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

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.

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.

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

Understanding future emissions from low-carbon power systems by integration of life-cycle assessment and integrated energy modelling

NASA Astrophysics Data System (ADS)

Pehl, Michaja; Arvesen, Anders; Humpenöder, Florian; Popp, Alexander; Hertwich, Edgar G.; Luderer, Gunnar

2017-12-01

Both fossil-fuel and non-fossil-fuel power technologies induce life-cycle greenhouse gas emissions, mainly due to their embodied energy requirements for construction and operation, and upstream CH4 emissions. Here, we integrate prospective life-cycle assessment with global integrated energy-economy-land-use-climate modelling to explore life-cycle emissions of future low-carbon power supply systems and implications for technology choice. Future per-unit life-cycle emissions differ substantially across technologies. For a climate protection scenario, we project life-cycle emissions from fossil fuel carbon capture and sequestration plants of 78-110 gCO2eq kWh-1, compared with 3.5-12 gCO2eq kWh-1 for nuclear, wind and solar power for 2050. Life-cycle emissions from hydropower and bioenergy are substantial (˜100 gCO2eq kWh-1), but highly uncertain. We find that cumulative emissions attributable to upscaling low-carbon power other than hydropower are small compared with direct sectoral fossil fuel emissions and the total carbon budget. Fully considering life-cycle greenhouse gas emissions has only modest effects on the scale and structure of power production in cost-optimal mitigation scenarios.

Is EQ-5D-5L Better Than EQ-5D-3L? A Head-to-Head Comparison of Descriptive Systems and Value Sets from Seven Countries.

PubMed

Janssen, Mathieu F; Bonsel, Gouke J; Luo, Nan

2018-06-01

This study describes the first empirical head-to-head comparison of EQ-5D-3L (3L) and EQ-5D-5L (5L) value sets for multiple countries. A large multinational dataset, including 3L and 5L data for eight patient groups and a student cohort, was used to compare 3L versus 5L value sets for Canada, China, England/UK (5L/3L, respectively), Japan, The Netherlands, South Korea and Spain. We used distributional analyses and two methods exploring discriminatory power: relative efficiency as assessed by the F statistic, and an area under the curve for the receiver-operating characteristics approach. Differences in outcomes were explored by separating descriptive system effects from valuation effects, and by exploring distributional location effects. In terms of distributional evenness, efficiency of scale use and the face validity of the resulting distributions, 5L was superior, leading to an increase in sensitivity and precision in health status measurement. When compared with 5L, 3L systematically overestimated health problems and consequently underestimated utilities. This led to bias, i.e. over- or underestimations of discriminatory power. We conclude that 5L provides more precise measurement at individual and group levels, both in terms of descriptive system data and utilities. The increased sensitivity and precision of 5L is likely to be generalisable to longitudinal studies, such as in intervention designs. Hence, we recommend the use of the 5L across applications, including economic evaluation, clinical and public health studies. The evaluative framework proved to be useful in assessing preference-based instruments and might be useful for future work in the development of descriptive systems or health classifications.

Using an Informative Missing Data Model to Predict the Ability to Assess Recovery of Balance Control after Spaceflight

NASA Technical Reports Server (NTRS)

Feiveson, Alan H.; Wood, Scott J.; Jain, Varsha

2008-01-01

Astronauts show degraded balance control immediately after spaceflight. To assess this change, astronauts' ability to maintain a fixed stance under several challenging stimuli on a movable platform is quantified by "equilibrium" scores (EQs) on a scale of 0 to 100, where 100 represents perfect control (sway angle of 0) and 0 represents data loss where no sway angle is observed because the subject has to be restrained from falling. By comparing post- to pre-flight EQs for actual astronauts vs. controls, we built a classifier for deciding when an astronaut has recovered. Future diagnostic performance depends both on the sampling distribution of the classifier as well as the distribution of its input data. Taking this into consideration, we constructed a predictive ROC by simulation after modeling P(EQ = 0) in terms of a latent EQ-like beta-distributed random variable with random effects.

Hydrologic monitoring and analysis in the Sundarbans mangrove ecosystem, Bangladesh

NASA Astrophysics Data System (ADS)

Wahid, Shahriar Md.; Babel, Mukand S.; Bhuiyan, Abdur Rahman

2007-01-01

SummaryThe unique habitat of the Sundarbans mangrove ecosystem is dependent upon the hydrological regime. Therefore, a comprehensive study to understand the hydrologic behaviour and the changes that have taken place due to anthropogenic activities in and around the area is fundamental to the management of natural resources and environment. In the past, ad hoc and uncoordinated efforts were made due to the inherent inaccessibility and high cost of data collection. The present article documents the results of the hydrologic monitoring, modelling and analysis in the Sundarbans. The study results show that the annual maximum tidal range has increased by about 0.75 m in the eastern and central parts during the last two decades. About 60% area remains in higher salinity condition (>20 ppt) for at least 1.5 months in a year. Organic pollution in the waterways is within the Environmental Quality Standard (EQS) of Bangladesh with the average Dissolved Oxygen (DO) of 5.99 mg/L. Total Ammonia, Nitrate (NO 3-N) and Phosphate (PO 4-P) level are present in sufficient quantity for the aquatic life to survive and are within EQS limit. Lead and Chromium occasionally exceed EQS limit especially along the large barge routes in the western part. The data and information presented in the paper will serve as a baseline for future hydrological and environmental studies.

Environmental impacts of high penetration renewable energy scenarios for Europe

NASA Astrophysics Data System (ADS)

Berrill, Peter; Arvesen, Anders; Scholz, Yvonne; Gils, Hans Christian; Hertwich, Edgar G.

2016-01-01

The prospect of irreversible environmental alterations and an increasingly volatile climate pressurises societies to reduce greenhouse gas emissions, thereby mitigating climate change impacts. As global electricity demand continues to grow, particularly if considering a future with increased electrification of heat and transport sectors, the imperative to decarbonise our electricity supply becomes more urgent. This letter implements outputs of a detailed power system optimisation model into a prospective life cycle analysis framework in order to present a life cycle analysis of 44 electricity scenarios for Europe in 2050, including analyses of systems based largely on low-carbon fossil energy options (natural gas, and coal with carbon capture and storage (CCS)) as well as systems with high shares of variable renewable energy (VRE) (wind and solar). VRE curtailments and impacts caused by extra energy storage and transmission capabilities necessary in systems based on VRE are taken into account. The results show that systems based largely on VRE perform much better regarding climate change and other impact categories than the investigated systems based on fossil fuels. The climate change impacts from Europe for the year 2050 in a scenario using primarily natural gas are 1400 Tg CO2-eq while in a scenario using mostly coal with CCS the impacts are 480 Tg CO2-eq. Systems based on renewables with an even mix of wind and solar capacity generate impacts of 120-140 Tg CO2-eq. Impacts arising as a result of wind and solar variability do not significantly compromise the climate benefits of utilising these energy resources. VRE systems require more infrastructure leading to much larger mineral resource depletion impacts than fossil fuel systems, and greater land occupation impacts than systems based on natural gas. Emissions and resource requirements from wind power are smaller than from solar power.

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.

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

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.

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.

Technical opportunities to reduce global anthropogenic emissions of nitrous oxide

NASA Astrophysics Data System (ADS)

Winiwarter, Wilfried; Höglund-Isaksson, Lena; Klimont, Zbigniew; Schöpp, Wolfgang; Amann, Markus

2018-01-01

We describe a consistent framework developed to quantify current and future anthropogenic emissions of nitrous oxide and the available technical abatement options by source sector for 172 regions globally. About 65% of the current emissions derive from agricultural soils, 8% from waste, and 4% from the chemical industry. Low-cost abatement options are available in industry, wastewater, and agriculture, where they are limited to large industrial farms. We estimate that by 2030, emissions can be reduced by about 6% ±2% applying abatement options at a cost lower than 10 €/t CO2-eq. The largest abatement potential at higher marginal costs is available from agricultural soils, employing precision fertilizer application technology as well as chemical treatment of fertilizers to suppress conversion processes in soil (nitrification inhibitors). At marginal costs of up to 100 €/t CO2-eq, about 18% ±6% of baseline emissions can be removed and when considering all available options, the global abatement potential increases to about 26% ±9%. Due to expected future increase in activities driving nitrous oxide emissions, the limited technical abatement potential available means that even at full implementation of reduction measures by 2030, global emissions can be at most stabilized at the pre-2010 level. In order to achieve deeper reductions in emissions, considerable technological development will be required as well as non-technical options like adjusting human diets towards moderate animal protein consumption.

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.

Prediction of frequency and exposure level of solar particle events.

PubMed

Kim, Myung-Hee Y; Hayat, Matthew J; Feiveson, Alan H; Cucinotta, Francis A

2009-07-01

For future space missions outside of the Earth's magnetic field, the risk of radiation exposure from solar particle events (SPEs) during extra-vehicular activities (EVAs) or in lightly shielded vehicles is a major concern when designing radiation protection including determining sufficient shielding requirements for astronauts and hardware. While the expected frequency of SPEs is strongly influenced by solar modulation, SPE occurrences themselves are chaotic in nature. We report on a probabilistic modeling approach, where a cumulative expected occurrence curve of SPEs for a typical solar cycle was formed from a non-homogeneous Poisson process model fitted to a database of proton fluence measurements of SPEs that occurred during the past 5 solar cycles (19-23) and those of large SPEs identified from impulsive nitrate enhancements in polar ice. From the fitted model, we then estimated the expected frequency of SPEs at any given proton fluence threshold with energy >30 MeV (Phi(30)) during a defined space mission period. Analytic energy spectra of 34 large SPEs observed in the space era were fitted over broad energy ranges extending to GeV, and subsequently used to calculate the distribution of mGy equivalent (mGy-Eq) dose for a typical blood-forming organ (BFO) inside a spacecraft as a function of total Phi(30) fluence. This distribution was combined with a simulation of SPE events using the Poisson model to estimate the probability of the BFO dose exceeding the NASA 30-d limit of 250 mGy-Eq per 30 d. These results will be useful in implementing probabilistic risk assessment approaches at NASA and guidelines for protection systems for astronauts on future space exploration missions.

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.

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.

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.

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.

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.

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.

A comparison of United States and United Kingdom EQ-5D health states valuations using a nonparametric Bayesian method.

PubMed

Kharroubi, Samer A; O'Hagan, Anthony; Brazier, John E

2010-07-10

Cost-effectiveness analysis of alternative medical treatments relies on having a measure of effectiveness, and many regard the quality adjusted life year (QALY) to be the current 'gold standard.' In order to compute QALYs, we require a suitable system for describing a person's health state, and a utility measure to value the quality of life associated with each possible state. There are a number of different health state descriptive systems, and we focus here on one known as the EQ-5D. Data for estimating utilities for different health states have a number of features that mean care is necessary in statistical modelling.There is interest in the extent to which valuations of health may differ between different countries and cultures, but few studies have compared preference values of health states obtained from different countries. This article applies a nonparametric model to estimate and compare EQ-5D health state valuation data obtained from two countries using Bayesian methods. The data set is the US and UK EQ-5D valuation studies where a sample of 42 states defined by the EQ-5D was valued by representative samples of the general population from each country using the time trade-off technique. We estimate a utility function across both countries which explicitly accounts for the differences between them, and is estimated using the data from both countries. The article discusses the implications of these results for future applications of the EQ-5D and for further work in this field. Copyright 2010 John Wiley & Sons, Ltd.

[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.

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.

Quantifying Health Utilities in Patients Undergoing Stereotactic Body Radiation Treatment for Liver Metastases for Use in Future Economic Evaluations.

PubMed

Warren, B; Munoz-Schuffenegger, P; Chan, K K W; Chu, W; Helou, J; Erler, D; Chung, H

2017-09-01

Stereotactic body radiation therapy (SBRT) is increasingly used as an option for those with liver metastases. In order to facilitate future economic impact of health technologies, health utility scores may be used. The EuroQOL-5D-3L (EQ-5D) preference-based healthy utility instrument was used to evaluate the impact of treatment with SBRT on health utility scores. Between August 2013 and October 2014, 31 patients treated with 3-5 fractions of SBRT for liver metastases were enrolled in this study. The EQ-5D instrument was administered at baseline, during and up to 6 months post-SBRT. Mean EQ-5D score at baseline was 0.857, which remained stable across the entire study time period. Transient increases in difficulties with mobility (9.7% reported at baseline to 16.1% on the last day of treatment) and usual activities (3.2% reported at baseline to 34.5% on day two) were found during the course of treatment; these returned to baseline levels subsequently. The mean visual analogue score at baseline was 65.8 and remained unchanged throughout treatment and follow-up. The stability of health utility scores and problems reported by patients undergoing treatment indicate that SBRT for liver metastases does not impart a significant adverse effect on quality of life. These results may be used for future economic evaluation of SBRT. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

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.

Emotional quotient in frontotemporal dementia vs. Alzheimer's disease: the role of socioemotional agnosia.

PubMed

Carr, Andrew R; Samimi, Mersal S; Paholpak, Pongsatorn; Jimenez, Elvira E; Mendez, Mario F

2017-01-01

Socioemotional dysfunction distinguishes behavioural variant frontotemporal dementia (bvFTD) from other dementias. Patients with bvFTD not only have early social impairment and emotional blunting, but they also have agnosia of their socioemotional dysfunction. To investigate the relationship between agnosia and dysfunction, we assessed self-knowledge of socioemotional dysfunction with an emotional quotient (EQ) scale administered to 12 patients with bvFTD and a comparison group of 12 age-matched patients with Alzheimer's disease (AD), and compared these self-ratings to caregiver ratings of social dysfunction and emotional blunting. The bvFTD patients self-rated as having higher EQs than the AD patients, particularly higher self-ratings of their Social Skills, an EQ subscale which correlated with increased emotional blunting. On within-groups analysis, the bvFTD patients' high self-ratings of their EQ Appraisal of Emotions correlated with increased socioemotional dysfunction, whereas all of the AD patients' self-ratings correlated appropriately with their degree of dysfunction. Large socioemotional agnosia scores (EQ minus function) distinguishes bvFTD from AD. Additionally, in bvFTD, agnosia specifically for their ability to appreciate others' emotions correlates with the degree of socioemotional dysfunction, suggesting a role for socioemotional agnosia in increasing socioemotional dysfunction.

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

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.

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.

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.

Equine alpha-fetoprotein levels in Lipizzaner mares with normal pregnancies and with pregnancy loss.

PubMed

Vincze, Boglárka; Gáspárdy, András; Kulcsár, Margit; Baska, Ferenc; Bálint, Ádám; Hegedűs, György Tamás; Szenci, Ottó

2015-12-01

Alpha-fetoprotein has proved to be a good indicator of fetal well-being in human medicine for decades. Although this molecule is present in most of the mammalian species including horses, reference values in healthy and high-risk pregnant mares have not yet been published. The aim of the present study was to determine whether equine alpha-fetoprotein (eqAFP) is a good indicator of complicated pregnancies in Lipizzaner mares. A total of 111 serum samples from 30 mares have been analyzed for eqAFP levels throughout gestation (Days 60-325). After the pregnancy was confirmed, 23 mares had normal pregnancies with viable foals, six had late embryonic loss, and one of the mares aborted in the ninth gestational month. Equine alpha-fetoprotein concentrations significantly differed in the normal group (72.93 ± 49.25 pg/mL; mean ± standard deviation) and in the complicated pregnancy loss group (152 ± 36.48 pg/mL; mean ± standard deviation). The mares' age, gestational age, and the conception rate significantly affected the alpha-fetoprotein concentrations in the normal group. Furthermore, notable individual differences occurred in eqAFP concentrations between mares. Equine alpha-fetoprotein seems to be an important indicator of fetal well-being in horses, but there are still some unanswered questions (levels in foals of different age, ponies, and draft horses) regarding this serum protein. Large-scale studies are needed to assess the specificity, sensitivity, and reliability of this test as a possible future diagnostic tool for fetal well-being in horses. Copyright © 2015 Elsevier Inc. All rights reserved.

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.

A Multi-year Multi-passband CCD Photometric Study of the W UMa Binary EQ Tauri

NASA Astrophysics Data System (ADS)

Alton, K. B.

2009-12-01

A revised ephemeris and updated orbital period for EQ Tau have been determined from newly acquired (2007-2009) CCD-derived photometric data. A Roche-type model based on the Wilson-Devinney code produced simultaneous theoretical fits of light curve data in three passbands by invoking cold spots on the primary component. These new model fits, along with similar light curve data for EQ Tau collected during the previous six seasons (2000-2006), provided a rare opportunity to follow the seasonal appearance of star spots on a W UMa binary system over nine consecutive years. Fixed values for q, ?1,2, T1, T2, and i based upon the mean of eleven separately determined model fits produced for this system are hereafter proposed for future light curve modeling of EQ Tau. With the exception of the 2001 season all other light curves produced since then required a spotted solution to address the flux asymmetry exhibited by this binary system at Max I and Max II. At least one cold spot on the primary appears in seven out of twelve light curves for EQ Tau produced over the last nine years, whereas in six instances two cold spots on the primary star were invoked to improve the model fit. Solutions using a hot spot were less common and involved positioning a single spot on the primary constituent during the 2001-2002, 2002-2003, and 2005-2006 seasons.

Current challenges for pre-earthquake electromagnetic emissions: shedding light from micro-scale plastic flow, granular packings, phase transitions and self-affinity notion of fracture process

NASA Astrophysics Data System (ADS)

Eftaxias, K.; Potirakis, S. M.

2013-10-01

Are there credible electromagnetic (EM) potential earthquake (EQ) precursors? This a question debated in the scientific community and there may be legitimate reasons for the critical views. The negative view concerning the existence of EM potential precursors is enhanced by features that accompany their observation which are considered as paradox ones, namely, these signals: (i) are not observed at the time of EQs occurrence and during the aftershock period, (ii) are not accompanied by large precursory strain changes, (iii) are not accompanied by simultaneous geodetic or seismological precursors and (iv) their traceability is considered problematic. In this work, the detected candidate EM potential precursors are studied through a shift in thinking towards the basic science findings relative to granular packings, micron-scale plastic flow, interface depinning, fracture size effects, concepts drawn from phase transitions, self-affine notion of fracture and faulting process, universal features of fracture surfaces, recent high quality laboratory studies, theoretical models and numerical simulations. We try to contribute to the establishment of strict criteria for the definition of an emerged EM anomaly as a possibly EQ-related one, and to the explanation of potential precursory EM features which have been considered as paradoxes. A three-stage model for EQ generation by means of pre-EQ fracture-induced EM emissions is proposed. The claim that the observed EM potential precursors may permit a real-time and step-by-step monitoring of the EQ generation is tested.

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

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.

On the large-scale structures formed by wakes of open cosmic strings

NASA Technical Reports Server (NTRS)

Hara, Tetsuya; Morioka, Shoji; Miyoshi, Shigeru

1990-01-01

Large-scale structures of the universe have been variously described as sheetlike, filamentary, cellular, bubbles or spongelike. Recently cosmic strings became one of viable candidates for a galaxy formation scenario, and some of the large-scale structures seem to be simply explained by the open cosmic strings. According to this scenario, sheets are wakes which are traces of moving open cosmic strings where dark matter and baryonic matter have accumulated. Filaments are intersections of such wakes and high density regions are places where three wakes intersect almost orthogonally. The wakes formed at t sub eq become the largest surface density among all wakes, where t sub eq is the epoch when matter density equals to radiation density. If we assume that there is one open cosmic string per each horizon, then it can be explained that the typical distances among wakes, filaments and clusters are also approx. 10(exp 2) Mpc. This model does not exclude a much more large scale structure. Open cosmic string may move even now and accumulate cold dark matter after its traces. However, the surface density is much smaller than the ones formed at t sub eq. From this model, it is expected that the typical high density region will have extended features such as six filaments and three sheets and be surrounded by eight empty regions (voids). Here, the authors are mainly concerned with such structures and have made numerical simulations for the formation of such large scale structures.

The suite of small-angle neutron scattering instruments at Oak Ridge National Laboratory

DOE PAGES

Heller, William T.; Cuneo, Matthew J.; Debeer-Schmitt, Lisa M.; ...

2018-02-21

Oak Ridge National Laboratory is home to the High Flux Isotope Reactor (HFIR), a high-flux research reactor, and the Spallation Neutron Source (SNS), the world's most intense source of pulsed neutron beams. The unique co-localization of these two sources provided an opportunity to develop a suite of complementary small-angle neutron scattering instruments for studies of large-scale structures: the GP-SANS and Bio-SANS instruments at the HFIR and the EQ-SANS and TOF-USANS instruments at the SNS. This article provides an overview of the capabilities of the suite of instruments, with specific emphasis on how they complement each other. As a result, amore » description of the plans for future developments including greater integration of the suite into a single point of entry for neutron scattering studies of large-scale structures is also provided.« less

The suite of small-angle neutron scattering instruments at Oak Ridge National Laboratory

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

Heller, William T.; Cuneo, Matthew J.; Debeer-Schmitt, Lisa M.

Oak Ridge National Laboratory is home to the High Flux Isotope Reactor (HFIR), a high-flux research reactor, and the Spallation Neutron Source (SNS), the world's most intense source of pulsed neutron beams. The unique co-localization of these two sources provided an opportunity to develop a suite of complementary small-angle neutron scattering instruments for studies of large-scale structures: the GP-SANS and Bio-SANS instruments at the HFIR and the EQ-SANS and TOF-USANS instruments at the SNS. This article provides an overview of the capabilities of the suite of instruments, with specific emphasis on how they complement each other. As a result, amore » description of the plans for future developments including greater integration of the suite into a single point of entry for neutron scattering studies of large-scale structures is also provided.« less

Carbon Sequestration in Colorado's Lands: A Spatial and Policy Analysis

NASA Astrophysics Data System (ADS)

Brandt, N.; Brazeau, A.; Browning, K.; Meier, R.

2017-12-01

Managing landscapes to enhance terrestrial carbon sequestration has significant potential to mitigate climate change. While a previous carbon baseline assessment in Colorado has been published (Conant et al, 2007), our study pulls from the existing literature to conduct an updated baseline assessment of carbon stocks and a unique review of carbon policies in Colorado. Through a multi-level spatial analysis based in GIS and informed by a literature review, we established a carbon stock baseline and ran four land use and carbon stock projection scenarios using Monte Carlo simulations. We identified 11 key policy recommendations for improving Colorado's carbon stocks, and evaluated each using Bardach's policy matrix approach (Bardach, 2012). We utilized a series of case studies to support our policy recommendations. We found that Colorado's lands have a carbon stock of 3,334 MMT CO2eq, with Forests and Woodlands holding the largest stocks, at 1,490 and 774 MMT CO2eq respectively. Avoided conversion of all Grasslands, Forests, and Wetlands in Colorado projected over 40 years would increase carbon stocks by 32 MMT CO2eq, 1,053 MMT CO2eq, and 36 MMT CO2eq, respectively. Over the 40-year study period, Forests and Woodlands areas are projected to shrink while Shrublands and Developed areas are projected to grow. Those projections suggest sizable increases in area of future wildfires and development in Colorado. We found that numerous policy opportunities to sequester carbon exist at different jurisdictional levels and across land cover types. The largest opportunities were found in state-level policies and policies impacting Forests, Grasslands, and Wetlands. The passage of statewide emission reduction legislation has the highest potential to impact carbon sequestration, although political and administrative feasibility of this option are relatively low. This study contributes to the broader field of carbon sequestration literature by examining the nexus of carbon stocks and policy at the state level, and serves as a model for future research on the role of terrestrial carbon stocks in climate change mitigation.

Earthquake-Ionosphere Coupling Processes

NASA Astrophysics Data System (ADS)

Kamogawa, Masashi

After a giant earthquake (EQ), acoustic and gravity waves are excited by the displacement of land and sea surface, propagate through atmosphere, and then reach thermosphere, which causes ionospheric disturbances. This phenomenon was detected first by ionosonde and by HF Doppler sounderin the 1964 M9.2 Great Alaskan EQ. Developing Global Positioning System (GPS), seismogenic ionospheric disturbance detected by total electron content (TEC) measurement has been reported. A value of TEC is estimated by the phase difference between two different carrier frequencies through the propagation in the dispersive ionospheric plasma. The variation of TEC is mostly similar to that of F-region plasma. Acoustic-gravity waves triggered by an earthquake [Heki and Ping, EPSL, 2005; Liu et al., JGR, 2010] and a tsunami [Artu et al., GJI, 2005; Liu et al., JGR, 2006; Rolland, GRL, 2010] disturb the ionosphere and travel in the ionosphere. Besides the traveling ionospheric disturbances, ionospheric disturbances excited by Rayleigh waves [Ducic et al, GRL, 2003; Liu et al., GRL, 2006] as well as post-seismic 4-minute monoperiodic atmospheric resonances [Choosakul et al., JGR, 2009] have been observed after the large earthquakes. Since GPS Earth Observation Network System (GEONET) with more than 1200 GPS receiving points in Japan is a dense GPS network, seismogenic ionospheric disturbance is spatially observed. In particular, the seismogenic ionospheric disturbance caused by the M9.0 off the Pacific coast of Tohoku EQ (henceforth the Tohoku EQ) on 11 March 2011 was clearly observed. Approximately 9 minutes after the mainshock, acoustic waves which propagated radially emitted from the tsunami source area were observed through the TEC measurement (e. g., Liu et al. [JGR, 2011]). Moreover, there was a depression of TEC lasting for several tens of minutes after a huge earthquake, which was a large-scale phenomenon extending to a radius of a few hundred kilometers. This TEC depression may be an ionospheric phenomenon attributed to tsunami, termed tsunamigenic ionospheric hole (TIH) [Kakinami and Kamogwa et al., GRL, 2012]. After the TEC depression accompanying a monoperiodic variation with approximately 4-minute period as an acoustic resonance between the ionosphere and the solid earth, the TIH gradually recovered. In addition, geomagnetic pulsations with the periods of 150, 180 and 210 seconds were observed on the ground in Japan approximately 5 minutes after the mainshock. Since the variation with the period of 180 seconds was simultaneously detected at the magnetic conjugate of points of Japan, namely Australia, field aligned currents along the magnetic field line were excited. The field aligned currents might be excited due to E and F region dynamo current caused by acoustic waves originating from the tsunami. This result implies that a large earthquake generates seismogenic field aligned currents. Furthermore, monoperiodical geomagnetic oscillation pointing to the epicenter of which velocity corresponds to Rayleigh waves occurs. This may occur due to seismogenic arc-current in E region. Removing such magnetic oscillations from the observed data, clear tsunami dynamo effect was found. This result implies that a large EQ generates seismogenic field aligned currents, seismogenic arc-current and tsunami dynamo current which disturb geomagnetic field. Thus, we found the complex coupling process between a large EQ and an ionosphere from the results of Tohoku EQ.

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

Statistical similarities of pre-earthquake electromagnetic emissions to biological and economic extreme events

NASA Astrophysics Data System (ADS)

Potirakis, Stelios M.; Contoyiannis, Yiannis; Kopanas, John; Kalimeris, Anastasios; Antonopoulos, George; Peratzakis, Athanasios; Eftaxias, Konstantinos; Nomicos, Costantinos

2014-05-01

When one considers a phenomenon that is "complex" refers to a system whose phenomenological laws that describe the global behavior of the system, are not necessarily directly related to the "microscopic" laws that regulate the evolution of its elementary parts. The field of study of complex systems considers that the dynamics of complex systems are founded on universal principles that may be used to describe disparate problems ranging from particle physics to economies of societies. Several authors have suggested that earthquake (EQ) dynamics can be analyzed within similar mathematical frameworks with economy dynamics, and neurodynamics. A central property of the EQ preparation process is the occurrence of coherent large-scale collective behavior with a very rich structure, resulting from repeated nonlinear interactions among the constituents of the system. As a result, nonextensive statistics is an appropriate, physically meaningful, tool for the study of EQ dynamics. Since the fracture induced electromagnetic (EM) precursors are observable manifestations of the underlying EQ preparation process, the analysis of a fracture induced EM precursor observed prior to the occurrence of a large EQ can also be conducted within the nonextensive statistics framework. Within the frame of the investigation for universal principles that may hold for different dynamical systems that are related to the genesis of extreme events, we present here statistical similarities of the pre-earthquake EM emissions related to an EQ, with the pre-ictal electrical brain activity related to an epileptic seizure, and with the pre-crisis economic observables related to the collapse of a share. It is demonstrated the all three dynamical systems' observables can be analyzed in the frame of nonextensive statistical mechanics, while the frequency-size relations of appropriately defined "events" that precede the extreme event related to each one of these different systems present striking quantitative similarities. It is also demonstrated that, for the considered systems, the nonextensive parameter q increases as the extreme event approaches, which indicates that the strength of the long-memory / long-range interactions between the constituents of the system increases characterizing the dynamics of the system.

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

Long-term quality of life after posterior cervical foraminotomy for radiculopathy.

PubMed

Faught, Ryan W; Church, Ephraim W; Halpern, Casey H; Balmuri, Usha; Attiah, Mark A; Stein, Sherman C; Dante, Stephen J; Welch, William C; Simeone, Frederick A

2016-03-01

Cervical radiculopathy may cause symptoms and loss of function that can lead to a significant reduction in health related quality of life (HRQOL). As part of a comprehensive review of long-term outcomes, we examined HRQOL in a large cohort of patients undergoing posterior cervical foraminotomy (FOR) for radiculopathy. 338 patients who underwent FOR between 1990 and 2009 participated in a telephone interview designed to measure symptomatic and functional improvements following surgery. We also administered the EQ-5D, a standardized tool for assessing HRQOL. We analyzed this data for associations between patient and treatment characteristics, improvements in symptoms and function, and HRQOL as measured by the EQ-5D. Mean follow-up was 10.0 years. The average EQ-5D at follow-up was 0.81±0.18, and improvements in pain, weakness and function as well as ability to return to work correlated with improved EQ-5D score (p<0.0001). There was no correlation between length of follow-up and EQ-5D score (p=0.980). Additionally, there was no difference between mean EQ-5D score for soft disc versus osteophyte pathology (0.84 versus 0.81, p=0.21). These data provide evidence that FOR for cervical radiculopathy is associated with improved HRQOL at long-term follow-up. The lack of correlation between length of follow-up and HRQOL suggests that FOR is a durable treatment option. Moreover, FOR is associated with improved HRQOL whether radiculopathy is due to soft disc or osteophyte pathology. Copyright © 2016 Elsevier B.V. All rights reserved.

Differences between individual and societal health state valuations: any link with personality?

PubMed

Chapman, Benjamin P; Franks, Peter; Duberstein, Paul R; Jerant, Anthony

2009-08-01

The concept of "adaptation" has been proposed to account for differences between individual and societal valuations of specific health states in patients with chronic diseases. Little is known about psychological indices of adaptational capacity, which may predict differences in individual and societal valuations of health states. We investigated whether such differences were partially explained by personality traits in chronic disease patients. Analysis of baseline data of randomized controlled trial. Three hundred seventy patients with chronic disease. The NEO-five factor inventory measure of personality, EuroQoL-5D (EQ-5D) societal-based, and the EQ visual analogue scale individually-based measures of health valuation. Regression analyses modeled Dev, a measure of difference between the EQ-Visual Analogue Scale and EQ-5D, as a function of personality traits, sociodemographic factors, and chronic diseases. Individual valuations were significantly and clinically higher than societal valuations among patients in the second and third quartile of conscientiousness (Dev = 0.08, P = 0.01); among covariates, only depression (Dev = -0.04, P = 0.046) was also associated with Dev. Compared with societal valuations of a given health state, persons at higher quartiles of conscientiousness report less disutility associated with poor health. The effect is roughly twice that of some estimates of minimally important clinical differences on the EQ-5D and of depression. Although useful at the aggregate level, societal preference measures may systematically undervalue the health states of more conscientious individuals. Future work should examine the impact this has on individual patient outcome evaluation in clinical studies.

Differences Between Individual and Societal Health State Valuations

PubMed Central

Chapman, Benjamin P.; Franks, Peter; Duberstein, Paul R.; Jerant, Anthony

2009-01-01

Objective The concept of “adaptation” has been proposed to account for differences between individual and societal valuations of specific health states in patients with chronic diseases. Little is known about psychological indices of adaptational capacity, which may predict differences in individual and societal valuations of health states. We investigated whether such differences were partially explained by personality traits in chronic disease patients. Research Design Analysis of baseline data of randomized controlled trial. Subjects Three hundred seventy patients with chronic disease. Measures The NEO-five factor inventory measure of personality, EuroQoL-5D (EQ-5D) societal-based, and the EQ visual analogue scale individually-based measures of health valuation. Results Regression analyses modeled Dev, a measure of difference between the EQ-Visual Analogue Scale and EQ-5D, as a function of personality traits, sociodemographic factors, and chronic diseases. Individual valuations were significantly and clinically higher than societal valuations among patients in the second and third quartile of conscientiousness (Dev = 0.08, P = 0.01); among covariates, only depression (Dev = -0.04, P = 0.046) was also associated with Dev. Conclusion Compared with societal valuations of a given health state, persons at higher quartiles of conscientiousness report less disutility associated with poor health. The effect is roughly twice that of some estimates of minimally important clinical differences on the EQ-5D and of depression. Although useful at the aggregate level, societal preference measures may systematically undervalue the health states of more conscientious individuals. Future work should examine the impact this has on individual patient outcome evaluation in clinical studies. PMID:19543121

Development and validation of a shared decision-making instrument for health-related quality of life one year after total hip replacement based on quality registries data.

PubMed

Nemes, Szilard; Rolfson, Ola; Garellick, Göran

2018-02-01

Clinicians considering improvements in health-related quality of life (HRQoL) after total hip replacement (THR) must account for multiple pieces of information. Evidence-based decisions are important to best assess the effect of THR on HRQoL. This work aims at constructing a shared decision-making tool that helps clinicians assessing the future benefits of THR by offering predictions of 1-year postoperative HRQoL of THR patients. We used data from the Swedish Hip Arthroplasty Register. Data from 2008 were used as training set and data from 2009 to 2012 as validation set. We adopted two approaches. First, we assumed a continuous distribution for the EQ-5D index and modelled the postoperative EQ-5D index with regression models. Second, we modelled the five dimensions of the EQ-5D and weighted together the predictions using the UK Time Trade-Off value set. As predictors, we used preoperative EQ-5D dimensions and the EQ-5D index, EQ visual analogue scale, visual analogue scale pain, Charnley classification, age, gender, body mass index, American Society of Anesthesiologists, surgical approach and prosthesis type. Additionally, the tested algorithms were combined in a single predictive tool by stacking. Best predictive power was obtained by the multivariate adaptive regression splines (R 2  = 0.158). However, this was not significantly better than the predictive power of linear regressions (R 2  = 0.157). The stacked model had a predictive power of 17%. Successful implementation of a shared decision-making tool that can aid clinicians and patients in understanding expected improvement in HRQoL following THR would require higher predictive power than we achieved. For a shared decision-making tool to succeed, further variables, such as socioeconomics, need to be considered. © 2016 John Wiley & Sons, Ltd.

Predictors of self-reported health-related quality of life according to the EQ-5D-Y in chronically ill children and adolescents with asthma, diabetes, and juvenile arthritis: longitudinal results.

PubMed

Otto, Christiane; Barthel, Dana; Klasen, Fionna; Nolte, Sandra; Rose, Matthias; Meyrose, Ann-Katrin; Klein, Marcus; Thyen, Ute; Ravens-Sieberer, Ulrike

2018-04-01

Health-related quality of life (HRQoL) is an important patient-reported outcome in clinical and health research. The EQ-5D-Y assesses child and adolescent HRQoL by five items on mobility, self-care, usual activities, pain/discomfort, and anxiety/depression as well as a visual analogue scale (VAS) on the current health state. This study investigates predictors of self-reported HRQoL according to the EQ-5D-Y in chronically ill children and adolescents using longitudinal data. Data from the German Kids-CAT study on children and adolescents with asthma, diabetes, and juvenile arthritis gathered over a period of six months were analyzed (n = 310; 7-17 years old; 48% female). Self-, parent-, and pediatrician-reported data were collected from June 2013 to October 2014. Generalized linear mixed models and linear mixed models served to examine effects of socio-demographic as well as disease- and health-specific predictors on the items as well as on the VAS of the EQ-5D-Y. Ceiling effects for the EQ-5D-Y indicated low burden of disease in the analyzed sample. Longitudinal analyses revealed associations between less health complaints and better HRQoL for all investigated HRQoL domains. Further, age- and gender-specific effects, and associations of better disease control, longer duration of the disease and less mental health problems with better HRQoL were found. Subjective health complaints and mental health problems should be considered in the care of children and adolescents with asthma, diabetes, and juvenile arthritis. Future research should suggest administering the items of the EQ-5D-Y with five instead of three response options, and investigate HRQoL over a longer period.

WebEQ: a web-GIS System to collect, display and query data for the management of the earthquake emergency in Central Italy

NASA Astrophysics Data System (ADS)

Carbone, Gianluca; Cosentino, Giuseppe; Pennica, Francesco; Moscatelli, Massimiliano; Stigliano, Francesco

2017-04-01

After the strong earthquakes that hit central Italy in recent months, the Center for Seismic Microzonation and its applications (CentroMS) was commissioned by the Italian Department of Civil Protection to conduct the study of seismic microzonation of the territories affected by the earthquake of August 24, 2016. As part of the activities of microzonation, IGAG CNR has created WebEQ, a management tool of the data that have been acquired by all participants (i.e., more than twenty research institutes and university departments). The data collection was organized and divided into sub-areas, assigned to working groups with multidisciplinary expertise in geology, geophysics and engineering. WebEQ is a web-GIS System that helps all the subjects involved in the data collection activities, through tools aimed at data uploading and validation, and with a simple GIS interface to display, query and download geographic data. WebEQ is contributing to the creation of a large database containing geographical data, both vector and raster, from various sources and types: - Regional Technical Map em Geological and geomorphological maps em Data location maps em Maps of microzones homogeneous in seismic perspective and seismic microzonation maps em National strong motion network location. Data loading is done through simple input masks that ensure consistency with the database structure, avoiding possible errors and helping users to interact with the map through user-friendly tools. All the data are thematized through standardized symbologies and colors (Gruppo di lavoro MS 2008), in order to allow the easy interpretation by all users. The data download tools allow data exchange between working groups and the scientific community to benefit from the activities. The seismic microzonation activities are still ongoing. WebEQ is enabling easy management of large amounts of data and will form a basis for the development of tools for the management of the upcoming seismic emergencies.

Very-high-Reynolds-number vortex dynamics via Coherent-vorticity-Preserving (CvP) Large-eddy simulations

NASA Astrophysics Data System (ADS)

Chapelier, Jean-Baptiste; Wasistho, Bono; Scalo, Carlo

2017-11-01

A new approach to Large-Eddy Simulation (LES) is introduced, where subgrid-scale (SGS) dissipation is applied proportionally to the degree of local spectral broadening, hence mitigated in regions dominated by large-scale vortical motion. The proposed CvP-LES methodology is based on the evaluation of the ratio of the test-filtered to resolved (or grid-filtered) enstrophy: σ = ξ ∧ / ξ . Values of σ = 1 indicate low sub-test-filter turbulent activity, justifying local deactivation of any subgrid-scale model. Values of σ < 1 span conditions ranging from incipient spectral broadening σ <= 1 , to equilibrium turbulence σ =σeq < 1 , where σeq is solely as a function of the test-to-grid filter-width ratio Δ ∧ / Δ , derived assuming a Kolmogorov's spectrum. Eddy viscosity is fully restored for σ <=σeq . The proposed approach removes unnecessary SGS dissipation, can be applied to any eddy-viscosity model, is algorithmically simple and computationally inexpensive. A CvP-LES of a pair of unstable helical vortices, representative of rotor-blade wake dynamics, show the ability of the method to sort the coherent motion from the small-scale dynamics. This work is funded by subcontract KSC-17-001 between Purdue University and Kord Technologies, Inc (Huntsville), under the US Navy Contract N68335-17-C-0159 STTR-Phase II, Purdue Proposal No. 00065007, Topic N15A-T002.

The circulation of the Dead Sea brine in the regional aquifer

NASA Astrophysics Data System (ADS)

Weber, Nurit; Yechieli, Yoseph; Stein, Mordechai; Yokochi, Reika; Gavrieli, Ittai; Zappala, Jake; Mueller, Peter; Lazar, Boaz

2018-07-01

Ca-chloride brines have circulated between the lakes and the adjacent aquifers throughout the history of the Dead Sea lacustrine-hydrology system. The Ein-Qedem (EQ) hydrothermal saline springs system discharging at the western shores of the modern Dead Sea is the modern manifestation of this essential and continuous process. The EQ springs comprise the most significant source of Ca-chloride brine that currently discharges into the lake. The chemical composition of EQ brine has remained virtually uniform during the past ca. 40 yr, indicating that the brine represents a large groundwater reservoir. The EQ brine evolved from ancient Ca-chloride brine that occupied the tectonic depression of the Dead Sea Basin during the Quaternary. During this period, the composition of lake's brine was affected by mixing with freshwater and formation of primary minerals. Based on chronological and geochemical data, we argue that the EQ brine comprises the epilimnetic solution of last glacial Lake Lisan that penetrated and circulated through the adjacent Judea Group aquifer. 14C and 81Kr dating indicates recharge ages spanning the time interval of ∼40-20 ka, coinciding with the period when the lake reached its highest stand (of ∼ 200 ± 30 m below msl, at ∼31-17.4 ka) and maintained a stable layered (stratified) configuration for a period of several ten thousand years. The presented evidence suggests that the circulation of the Ca-chloride brine involves penetration into the aquifer during high stands (EQ brine recharge) and its discharge back into the lake during the modern low stands (∼400 to 430 m below msl). Accordingly, the mechanism of brine circulation between the lake and the marginal aquifers is related to the long-term hydro-climate history of the Dead Sea basin and its vicinity.

The burden of common skin diseases assessed with the EQ5D™: a European multicentre study in 13 countries.

PubMed

Balieva, F; Kupfer, J; Lien, L; Gieler, U; Finlay, A Y; Tomás-Aragonés, L; Poot, F; Misery, L; Sampogna, F; van Middendorp, H; Halvorsen, J A; Szepietowski, J C; Lvov, A; Marrón, S E; Salek, M S; Dalgard, F J

2017-05-01

Generic instruments measuring health-related quality of life (HRQoL), like EQ5D™, enable comparison of skin diseases with healthy populations and nondermatological medical conditions, as well as calculation of utility data. To measure HRQoL in patients with common skin diseases and healthy controls across Europe using the EQ5D. This multicentre observational cross-sectional study was conducted in 13 European countries. Each dermatology clinic recruited at least 250 consecutive adult outpatients to complete questionnaires, including the EQ5D. There were 5369 participants (4010 patients and 1359 controls). Mean ± SD self-rated health state reported by patients was 69·9 ± 19·7; for controls it was 82·2 ± 15·5. When adjusted for confounding factors, including comorbidity, mean patient EQ visual analogue scores were 10·5 points lower than for controls (standardized β = -0·23). Odds ratio with 95% confidence interval for impairment in all five dimensions of EQ5D adjusted for confounders was doubled for patients compared with controls. Patients with hidradenitis suppurativa (HS), blistering conditions, leg ulcers, psoriasis and eczemas had the highest risk for reduction in HRQoL in most dimensions (2-10-fold). Data on differences of impairment by dimensions offer new insights. This study confirms the large impact skin conditions have on patients' well-being, differentiating between aspects of HRQoL. Patients with HS, blistering diseases, leg ulcers, infections and most chronic skin diseases reported reduced HRQoL compared with patients with chronic obstructive lung disease, diabetes mellitus, cardiovascular disease and cancers. These findings are important in the prioritization of resource allocation between medical fields and within dermatological subspecialities. © 2016 British Association of Dermatologists.

Estimation of local scale dispersion from local breakthrough curves during a tracer test in a heterogeneous aquifer: the Lagrangian approach.

PubMed

Vanderborght, Jan; Vereecken, Harry

2002-01-01

The local scale dispersion tensor, Dd, is a controlling parameter for the dilution of concentrations in a solute plume that is displaced by groundwater flow in a heterogeneous aquifer. In this paper, we estimate the local scale dispersion from time series or breakthrough curves, BTCs, of Br concentrations that were measured at several points in a fluvial aquifer during a natural gradient tracer test at Krauthausen. Locally measured BTCs were characterized by equivalent convection dispersion parameters: equivalent velocity, v(eq)(x) and expected equivalent dispersivity, [lambda(eq)(x)]. A Lagrangian framework was used to approximately predict these equivalent parameters in terms of the spatial covariance of log(e) transformed conductivity and the local scale dispersion coefficient. The approximate Lagrangian theory illustrates that [lambda(eq)(x)] increases with increasing travel distance and is much larger than the local scale dispersivity, lambda(d). A sensitivity analysis indicates that [lambda(eq)(x)] is predominantly determined by the transverse component of the local scale dispersion and by the correlation scale of the hydraulic conductivity in the transverse to flow direction whereas it is relatively insensitive to the longitudinal component of the local scale dispersion. By comparing predicted [lambda(eq)(x)] for a range of Dd values with [lambda(eq)(x)] obtained from locally measured BTCs, the transverse component of Dd, DdT, was estimated. The estimated transverse local scale dispersivity, lambda(dT) = DdT/U1 (U1 = mean advection velocity) is in the order of 10(1)-10(2) mm, which is relatively large but realistic for the fluvial gravel sediments at Krauthausen.

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.

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.

Greenhouse gas emissions from agricultural food production to supply Indian diets: Implications for climate change mitigation.

PubMed

Vetter, Sylvia H; Sapkota, Tek B; Hillier, Jon; Stirling, Clare M; Macdiarmid, Jennie I; Aleksandrowicz, Lukasz; Green, Rosemary; Joy, Edward J M; Dangour, Alan D; Smith, Pete

2017-01-16

Agriculture is a major source of greenhouse gas (GHG) emissions globally. The growing global population is putting pressure on agricultural production systems that aim to secure food production while minimising GHG emissions. In this study, the GHG emissions associated with the production of major food commodities in India are calculated using the Cool Farm Tool. GHG emissions, based on farm management for major crops (including cereals like wheat and rice, pulses, potatoes, fruits and vegetables) and livestock-based products (milk, eggs, chicken and mutton meat), are quantified and compared. Livestock and rice production were found to be the main sources of GHG emissions in Indian agriculture with a country average of 5.65 kg CO 2 eq kg -1 rice, 45.54 kg CO 2 eq kg -1 mutton meat and 2.4 kg CO 2 eq kg -1 milk. Production of cereals (except rice), fruits and vegetables in India emits comparatively less GHGs with <1 kg CO 2 eq kg -1 product. These findings suggest that a shift towards dietary patterns with greater consumption of animal source foods could greatly increase GHG emissions from Indian agriculture. A range of mitigation options are available that could reduce emissions from current levels and may be compatible with increased future food production and consumption demands in India.

Use of a macroinvertebrate based biotic index to estimate critical metal concentrations for good ecological water quality.

PubMed

Van Ael, Evy; De Cooman, Ward; Blust, Ronny; Bervoets, Lieven

2015-01-01

Large datasets from total and dissolved metal concentrations in Flemish (Belgium) fresh water systems and the associated macroinvertebrate-based biotic index MMIF (Multimetric Macroinvertebrate Index Flanders) were used to estimate critical metal concentrations for good ecological water quality, as imposed by the European Water Framework Directive (2000). The contribution of different stressors (metals and water characteristics) to the MMIF were studied by constructing generalized linear mixed effect models. Comparison between estimated critical concentrations and the European and Flemish EQS, shows that the EQS for As, Cd, Cu and Zn seem to be sufficient to reach a good ecological quality status as expressed by the invertebrate-based biotic index. In contrast, the EQS for Cr, Hg and Pb are higher than the estimated critical concentrations, which suggests that when environmental concentrations are at the same level as the EQS a good quality status might not be reached. The construction of mixed models that included metal concentrations in their structure did not lead to a significant outcome. However, mixed models showed the primary importance of water characteristics (oxygen level, temperature, ammonium concentration and conductivity) for the MMIF. Copyright © 2014 Elsevier Ltd. All rights reserved.

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 Post-Dam System. Volume 4. Relational Data Base Management System (RDBMS)

DTIC Science & Technology

1992-10-01

15 THEN LOAD item FROM b15.mat ENDIF IF vfle EQ 16 THEN LOAD item FROM b16 .mat ENDIF IF vfle EQ 17 THEN LOAD item FROM b17.mat ENDIF IF vfle EQ 18...vple EQ 16 THEN LOAD reqet FROM bl6 .eqp ENDIF IF vple EQ 17 THEN LOAD reqet FROM bl7.eqp ENDIF IF vple EQ 18 THEN LOAD reqet FROM bl8.eqp ENDIF IF vple...b3.out ENDIF IF tWle EQ 14 THEN TYPE b14.out ENDIF IF tWle EQ 15 THEN 70 TYPE bIS.out ENDIF IF tfle EQ 16 THEN TYPE b16 .out ENDIF IF tfle EQ 17 THEN

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

Control of adaptive optic element displacement with the help of a magnetic rheology drive

NASA Astrophysics Data System (ADS)

Deulin, Eugeni A.; Mikhailov, Valeri P.; Sytchev, Victor V.

2000-10-01

The control system of adaptive optic of a large astronomical segmentated telescope was designed and tested. The dynamic model and the amplitude-frequency analysis of the new magnetic rheology (MR) drive are presented. The loop controlled drive consists of hydrostatic carrier, MR hydraulic loop controlling system, elastic thin wall seal, stainless seal which are united in a single three coordinate manipulator. This combination ensures short positioning error (delta) (phi)

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

Testbeam results of irradiated ams H18 HV-CMOS pixel sensor prototypes

DOE PAGES

Benoit, M.; Braccini, S.; Casse, G.; ...

2018-02-08

HV-CMOS pixel sensors are a promising option for the tracker upgrade of the ATLAS experiment at the LHC, as well as for other future tracking applications in which large areas are to be instrumented with radiation-tolerant silicon pixel sensors. We present results of testbeam characterisations of the 4 th generation of Capacitively Coupled Pixel Detectors (CCPDv4) produced with the ams H18 HV-CMOS process that have been irradiated with different particles (reactor neutrons and 18 MeV protons) to fluences between 1×10 14 and 5×10 15 1–MeV– n eq. The sensors were glued to ATLAS FE-I4 pixel readout chips and measured atmore » the CERN SPS H8 beamline using the FE-I4 beam telescope. Results for all fluences are very encouraging with all hit efficiencies being better than 97% for bias voltages of 85 V. The sample irradiated to a fluence of 1×10 15 neq—a relevant value for a large volume of the upgraded tracker—exhibited 99.7% average hit efficiency. Furthermore, the results give strong evidence for the radiation tolerance of HV-CMOS sensors and their suitability as sensors for the experimental HL-LHC upgrades and future large-area silicon-based tracking detectors in high-radiation environments.« less

Testbeam results of irradiated ams H18 HV-CMOS pixel sensor prototypes

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

Benoit, M.; Braccini, S.; Casse, G.

HV-CMOS pixel sensors are a promising option for the tracker upgrade of the ATLAS experiment at the LHC, as well as for other future tracking applications in which large areas are to be instrumented with radiation-tolerant silicon pixel sensors. We present results of testbeam characterisations of the 4 th generation of Capacitively Coupled Pixel Detectors (CCPDv4) produced with the ams H18 HV-CMOS process that have been irradiated with different particles (reactor neutrons and 18 MeV protons) to fluences between 1×10 14 and 5×10 15 1–MeV– n eq. The sensors were glued to ATLAS FE-I4 pixel readout chips and measured atmore » the CERN SPS H8 beamline using the FE-I4 beam telescope. Results for all fluences are very encouraging with all hit efficiencies being better than 97% for bias voltages of 85 V. The sample irradiated to a fluence of 1×10 15 neq—a relevant value for a large volume of the upgraded tracker—exhibited 99.7% average hit efficiency. Furthermore, the results give strong evidence for the radiation tolerance of HV-CMOS sensors and their suitability as sensors for the experimental HL-LHC upgrades and future large-area silicon-based tracking detectors in high-radiation environments.« less

Impact on carbon footprint: a life cycle assessment of disposable versus reusable sharps containers in a large US hospital.

PubMed

Grimmond, Terry; Reiner, Sandra

2012-06-01

Hospitals are striving to reduce their greenhouse gas (GHG) emissions. Targeting supply chain points and replacing disposable with reusable items are among recommendations to achieve this. Annually, US hospitals use 35 million disposable (DSC) or reusable sharps containers (RSC) generating GHG in their manufacture, use, and disposal. Using a life cycle assessment we assessed the global warming potential (GWP) of both systems at a large US hospital which replaced DSC with RSC. GHG emissions (CO(2), CH(4), N(2)O) were calculated in metric tons of CO(2) equivalents (MTCO(2)eq). Primary energy input data was used wherever possible and region-specific conversions used to calculate the GWP of each activity. Unit process GHGs were collated into manufacture, transport, washing, and treatment and disposal. The DSC were not recycled nor had recycled content. Chemotherapy DSC were used in both systems. Emission totals were workload-normalized per 100 occupied beds-yr and rate ratio analyzed using Fisher's test with P ≤0.05 and 95% confidence level. With RSC, the hospital reduced its annual GWP by 127 MTCO(2)eq (-83.5%) and diverted 30.9 tons of plastic and 5.0 tons of cardboard from landfill. Using RSC reduced the number of containers manufactured from 34,396 DSC annually to 1844 RSC in year one only. The study indicates sharps containment GWP in US hospitals totals 100,000 MTCO(2)eq and if RSC were used nationally the figure could fall by 64,000 MTCO(2)eq which, whilst only a fraction of total hospital GWP, is a positive, sustainable step.

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.…

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.

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.

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.

An Empirical Comparison of the EQ-5D-5L, DEMQOL-U and DEMQOL-Proxy-U in a Post-Hospitalisation Population of Frail Older People Living in Residential Aged Care.

PubMed

Ratcliffe, Julie; Flint, Thomas; Easton, Tiffany; Killington, Maggie; Cameron, Ian; Davies, Owen; Whitehead, Craig; Kurrle, Susan; Miller, Michelle; Liu, Enwu; Crotty, Maria

2017-06-01

To empirically compare the measurement properties of the DEMQOL-U and DEMQOL-Proxy-U instruments to the EQ-5D-5L and its proxy version (CEQ-5D-5L) in a population of frail older people living in residential aged care in the post-hospitalisation period following a hip fracture. A battery of instruments to measure health-related quality of life (HRQoL), cognition, and clinical indicators of depression, pain and functioning were administered at baseline and repeated at 4 weeks' follow-up. Descriptive summary statistics were produced and psychometric analyses were conducted to assess the levels of agreement, convergent validity and known group validity between clinical indicators and HRQoL measures. There was a large divergence in mean (SD) utility scores at baseline for the EQ-5D-5L and DEMQOL-U [EQ-5D-5L mean 0.21 (0.19); DEMQOL-U mean 0.79 (0.14)]. At 4 weeks' follow-up, there was a marked improvement in EQ-5D-5L scores whereas DEMQOL-U scores had deteriorated. [EQ-5D-5L mean 0.45 (0.38); DEMQOL-U mean 0.58 (0.38)]. The EQ-5D and CEQ-5D-5L were more responsive to the physical recovery trajectory experienced by frail older people following surgery to repair a fractured hip, whereas the DEMQOL-U and DEMQOL-Proxy-U appeared more responsive to the changes in delirium and dementia symptoms often experienced by frail older people in this period. This study presents important insights into the HRQoL of a relatively under-researched population of post-hospitalisation frail older people in residential care. Further research should investigate the implications for economic evaluation of self-complete versus proxy assessment of HRQoL and the choice of preference-based instrument for the measurement and valuation of HRQoL in older people exhibiting cognitive decline, dementia and other co-morbidities.

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.

Farm systems assessment of bioenergy feedstock production: Integrating bio-economic models and life cycle analysis approaches

PubMed Central

Glithero, N.J.; Ramsden, S.J.; Wilson, P.

2012-01-01

Climate change and energy security concerns have driven the development of policies that encourage bioenergy production. Meeting EU targets for the consumption of transport fuels from bioenergy by 2020 will require a large increase in the production of bioenergy feedstock. Initially an increase in ‘first generation’ biofuels was observed, however ‘food competition’ concerns have generated interest in second generation biofuels (SGBs). These SGBs can be produced from co-products (e.g. cereal straw) or energy crops (e.g. miscanthus), with the former largely negating food competition concerns. In order to assess the sustainability of feedstock supply for SGBs, the financial, environmental and energy costs and benefits of the farm system must be quantified. Previous research has captured financial costs and benefits through linear programming (LP) approaches, whilst environmental and energy metrics have been largely been undertaken within life cycle analysis (LCA) frameworks. Assessing aspects of the financial, environmental and energy sustainability of supplying co-product second generation biofuel (CPSGB) feedstocks at the farm level requires a framework that permits the trade-offs between these objectives to be quantified and understood. The development of a modelling framework for Managing Energy and Emissions Trade-Offs in Agriculture (MEETA Model) that combines bio-economic process modelling and LCA is presented together with input data parameters obtained from literature and industry sources. The MEETA model quantifies arable farm inputs and outputs in terms of financial, energy and emissions results. The model explicitly captures fertiliser: crop-yield relationships, plus the incorporation of straw or removal for sale, with associated nutrient impacts of incorporation/removal on the following crop in the rotation. Key results of crop-mix, machinery use, greenhouse gas (GHG) emissions per kg of crop product and energy use per hectare are in line with previous research and industry survey findings. Results show that the gross margin – energy trade-off is £36 GJ−1, representing the gross margin forgone by maximising net farm energy cf. maximising farm gross margin. The gross margin–GHG emission trade-off is £0.15 kg−1 CO2 eq, representing the gross margin forgone per kg of CO2 eq reduced when GHG emissions are minimised cf. maximising farm gross margin. The energy–GHG emission trade-off is 0.03 GJ kg−1 CO2 eq quantifying the reduction in net energy from the farm system per kg of CO2 eq reduced when minimising GHG emissions cf. maximising net farm energy. When both farm gross margin and net farm energy are maximised all the cereal straw is baled for sale. Sensitivity analysis of the model in relation to different prices of cereal straw shows that it becomes financially optimal to incorporate wheat straw at price of £11 t−1 for this co-product. Local market conditions for straw and farmer attitudes towards incorporation or sale of straw will impact on the straw price at which farmers will supply this potential bioenergy feedstock and represent important areas for future research. PMID:25540473

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

Evolutionary characters, phenotypes and ontologies: curating data from the systematic biology literature.

PubMed

Dahdul, Wasila M; Balhoff, James P; Engeman, Jeffrey; Grande, Terry; Hilton, Eric J; Kothari, Cartik; Lapp, Hilmar; Lundberg, John G; Midford, Peter E; Vision, Todd J; Westerfield, Monte; Mabee, Paula M

2010-05-20

The wealth of phenotypic descriptions documented in the published articles, monographs, and dissertations of phylogenetic systematics is traditionally reported in a free-text format, and it is therefore largely inaccessible for linkage to biological databases for genetics, development, and phenotypes, and difficult to manage for large-scale integrative work. The Phenoscape project aims to represent these complex and detailed descriptions with rich and formal semantics that are amenable to computation and integration with phenotype data from other fields of biology. This entails reconceptualizing the traditional free-text characters into the computable Entity-Quality (EQ) formalism using ontologies. We used ontologies and the EQ formalism to curate a collection of 47 phylogenetic studies on ostariophysan fishes (including catfishes, characins, minnows, knifefishes) and their relatives with the goal of integrating these complex phenotype descriptions with information from an existing model organism database (zebrafish, http://zfin.org). We developed a curation workflow for the collection of character, taxonomic and specimen data from these publications. A total of 4,617 phenotypic characters (10,512 states) for 3,449 taxa, primarily species, were curated into EQ formalism (for a total of 12,861 EQ statements) using anatomical and taxonomic terms from teleost-specific ontologies (Teleost Anatomy Ontology and Teleost Taxonomy Ontology) in combination with terms from a quality ontology (Phenotype and Trait Ontology). Standards and guidelines for consistently and accurately representing phenotypes were developed in response to the challenges that were evident from two annotation experiments and from feedback from curators. The challenges we encountered and many of the curation standards and methods for improving consistency that we developed are generally applicable to any effort to represent phenotypes using ontologies. This is because an ontological representation of the detailed variations in phenotype, whether between mutant or wildtype, among individual humans, or across the diversity of species, requires a process by which a precise combination of terms from domain ontologies are selected and organized according to logical relations. The efficiencies that we have developed in this process will be useful for any attempt to annotate complex phenotypic descriptions using ontologies. We also discuss some ramifications of EQ representation for the domain of systematics.

Analyzing Health-Related Quality of Life Data to Estimate Parameters for Cost-Effectiveness Models: An Example Using Longitudinal EQ-5D Data from the SHIFT Randomized Controlled Trial.

PubMed

Griffiths, Alison; Paracha, Noman; Davies, Andrew; Branscombe, Neil; Cowie, Martin R; Sculpher, Mark

2017-03-01

The aim of this article is to discuss methods used to analyze health-related quality of life (HRQoL) data from randomized controlled trials (RCTs) for decision analytic models. The analysis presented in this paper was used to provide HRQoL data for the ivabradine health technology assessment (HTA) submission in chronic heart failure. We have used a large, longitudinal EuroQol five-dimension questionnaire (EQ-5D) dataset from the Systolic Heart Failure Treatment with the I f Inhibitor Ivabradine Trial (SHIFT) (clinicaltrials.gov: NCT02441218) to illustrate issues and methods. HRQoL weights (utility values) were estimated from a mixed regression model developed using SHIFT EQ-5D data (n = 5313 patients). The regression model was used to predict HRQoL outcomes according to treatment, patient characteristics, and key clinical outcomes for patients with a heart rate ≥75 bpm. Ivabradine was associated with an HRQoL weight gain of 0.01. HRQoL weights differed according to New York Heart Association (NYHA) class (NYHA I-IV, no hospitalization: standard care 0.82-0.46; ivabradine 0.84-0.47). A reduction in HRQoL weight was associated with hospitalizations within 30 days of an HRQoL assessment visit, with this reduction varying by NYHA class [-0.07 (NYHA I) to -0.21 (NYHA IV)]. The mixed model explained variation in EQ-5D data according to key clinical outcomes and patient characteristics, providing essential information for long-term predictions of patient HRQoL in the cost-effectiveness model. This model was also used to estimate the loss in HRQoL associated with hospitalizations. In SHIFT many hospitalizations did not occur close to EQ-5D visits; hence, any temporary changes in HRQoL associated with such events would not be captured fully in observed RCT evidence, but could be predicted in our cost-effectiveness analysis using the mixed model. Given the large reduction in hospitalizations associated with ivabradine this was an important feature of the analysis. The Servier Research Group.

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

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.

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.

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.

[Characteristics and determinants of informal care in chronic diseases in Hungary: a comparative analysis].

PubMed

Beretzky, Zsuzsanna; Péntek, Márta

2017-12-01

Informal care plays an important role in ageing societies. To analyse informal care use and its determinants among patients with chronic diseases in Hungary. Patient level data from previous studies in 14 diagnoses were analysed including patients' EQ-5D-3L health status. Descriptive statistics were performed and a linear regression model was built to analyse determinants of informal care time. 2047 patients (female: 58%) with mean age of 58.9 (SD = 16.3) years and EQ-5D-3L index score of 0.64 (SD = 0.33) were involved. 27% received informal care, the average time of care was 7.54 (SD = 26.36) hours/week. Both the rate of informal care use and its time differed significantly between the diagnoses (p<0.05), the highest were in dementia, Parkinsons' disease and in chronic inflammatory immunological diseases. Significant determinants were age, EQ-5D-3L scores, gender and certain diagnosis dummys (R 2 = 0.111). Informal care use is significant in chronic debilitating conditions. Future studies are encouraged to reveal unmet needs, preferences and further explanatory factors. Orv Hetil. 2017; 158(52): 2068-2078.

The use of the EQ-5D-Y health related quality of life outcome measure in children in the Western Cape, South Africa: psychometric properties, feasibility and usefulness - a longitudinal, analytical study.

PubMed

Scott, Des; Ferguson, Gillian D; Jelsma, Jennifer

2017-01-19

The EQ-5D-Y, an outcome measure of Health Related Quality of Life (HRQoL) in children, was developed by an international task team in 2010. The multinational feasibility, reliability and validity study which followed was undertaken with mainly healthy children. The aim of this study was to investigate the psychometric properties of the EQ-5D-Y when used to assess the HRQoL of children with different health states. A sample of 224 children between eight and twelve years were grouped according to their health state. The groups included 52 acutely ill children, 67 children with either a chronic health condition or disability and 105 mostly healthy, mainstream school children as a comparator. They were assessed at baseline, at three months and at six months. An analysis of the psychometric properties was performed to assess the reliability, validity and responsiveness of the EQ-5D-Y in the different groups of children. Cohen's kappa, the intraclass correlation coefficient, Pearson Chi-square, Kruskal-Wallis ANOVA and effect size of Wilcoxon Signed-rank test were used to determine the reliability, validity and responsiveness of the instrument. The EQ-5D-Y dimensions were found to be reliable on test-retest (kappa varying from 0.365 to 0.653), except for the Usual Activities dimension (kappa 0.199). The Visual Analogue Scale (VAS) was also reliable (ICC = 0.77). Post-hoc analysis indicated that dimensions were able to discriminate between acutely ill and healthy children (all differences p < 0.001). The acutely ill children had the lowest ranked VAS (median 50, range 0-100), indicating worst HRQoL and was the only group significantly different from the other three groups (p < 0.001 in all cases). Convergent validity between all similar EQ-5D-Y and PedsQL, WeeFIM and Faces Pain Scale dimensions was only evident in the acutely ill children. As expected the largest treatment effect was also observed in these children (Wilcoxon Signed-rank test for VAS was 0.43). Six of the nine therapists who took part in the study, found the measure quick and easy to apply, used the information in the management of the child and would continue to use it in future. The EQ-5D-Y could be used with confidence as an outcome measure for acutely-ill children, but demonstrated poorer psychometric properties in children with no health condition or chronic conditions. It appears to be feasible and useful to include the EQ-5D-Y in routine assessments of children.

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

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.

Emission Inventory of Halogenated greenhouse gases in China during 1980-2050

NASA Astrophysics Data System (ADS)

Fang, X.; Velders, G. J. M.; Ravishankara, A. R.; Molina, M.; Su, S.; Zhang, J.; Zhou, X.; Hu, J.; Prinn, R. G.

2015-12-01

China is currently the largest producer and consumer of ozone-depleting substances (ODSs) which are regulated by the Montreal Protocol (MP). Many ODSs are also powerful greenhouse gases (GHGs). The Multilateral Fund has subsidized ~1 billion US dollars for the ODS phase out in China, and thus the return on this investment is of great interest. This study gives a comprehensive emission inventory in China from 1980 to 2013 of halocarbons including ODSs and their alternatives, the hydrofluorocarbons (HFCs) that are also greenhouse gases. We then project these emissions up to 2050 according to the MP and several policy options. Total emissions of ODS and HFCs were estimated to be ~500 CO2-eq Tg/yr in 2013 which are equivalent to ~5% of total GHG emissions in China including fossil fuel CO2 emissions. Our estimate shows that China has succeeded in substantially reducing CFC-11-equivalent emissions (to protect the ozone layer), and CO2-equivalent emissions (to protect climate) of ODSs since the mid-1990s when their phase out started in China in compliance with the MP. Furthermore, the avoided CO2-eq emissions due to compliance with the MP are even greater compared to the reduced emissions, for example net cumulative avoided emissions during 19 year period between 1995-2013 are comparable to the current one year CO2 emissions from fossil fuels in China. We find that HFC CO2-eq emissions increased rapidly in last decade, which make up ~2% in 2005 to ~20% of total halocarbon CO2-eq emissions in 2013. Under a baseline scenario in which HFCs are used as alternatives in the ongoing phase out of HCFCs in China, emissions of HFCs are predicted to be important components of both China's and global future GHG emissions. However, potential exists for minimizing China's HFC emissions under mitigation scenarios. Our conclusions about China's past and future ODS and HFC emission trajectories are likely to apply to other developing countries, with important implications for mitigating global GHG emissions.

Population-Based Preference Weights for the EQ-5D Health States Using the Visual Analogue Scale (VAS) in Iran.

PubMed

Goudarzi, Reza; Zeraati, Hojjat; Akbari Sari, Ali; Rashidian, Arash; Mohammad, Kazem

2016-02-01

Health-related quality of life (HRQoL) is used as a measure to valuate healthcare interventions and guide policy making. The EuroQol EQ-5D is a widely used generic preference-based instrument to measure Health-related quality of life. The objective of this study was to develop a value set of the EQ-5D health states for an Iranian population. This study is a cross-sectional study of Iranian populations. Our sample from Iranian populations consists out of 869 participants, who were selected for this study using a stratified probability sampling method. The sample was taken from individuals living in the city of Tehran and was stratified by age and gender from July to November 2013. Respondents valued 13 health states using the visual analogue scale (VAS) of the EQ-5D. Several fixed effects regression models were tested to predict the full set of health states. We selected the final model based on the logical consistency of the estimates, the sign and magnitude of the regression coefficients, goodness of fit, and parsimony. We also compared predicted values with a value set from similar studies in the UK and other countries. Our results show that the HRQoL does not vary among socioeconomic groups. Models at the individual level resulted in an additive model with all coefficients being statistically significant, R(2) = 0.55, a value of 0.75 for the best health state (11112), and a value of -0.074 for the worst health state (33333). The value set obtained for the study sample remarkably differs from those elicited in developed countries. This study is the first estimate for the EQ-5D value set based on the VAS in Iran. Given the importance of locally adapted value set the use of this value set can be recommended for future studies in Iran and In the EMRO regions.

Effect-based trigger values for in vitro and in vivo bioassays performed on surface water extracts supporting the environmental quality standards (EQS) of the European Water Framework Directive.

PubMed

Escher, Beate I; Aїt-Aїssa, Selim; Behnisch, Peter A; Brack, Werner; Brion, François; Brouwer, Abraham; Buchinger, Sebastian; Crawford, Sarah E; Du Pasquier, David; Hamers, Timo; Hettwer, Karina; Hilscherová, Klára; Hollert, Henner; Kase, Robert; Kienle, Cornelia; Tindall, Andrew J; Tuerk, Jochen; van der Oost, Ron; Vermeirssen, Etienne; Neale, Peta A

2018-07-01

Effect-based methods including cell-based bioassays, reporter gene assays and whole-organism assays have been applied for decades in water quality monitoring and testing of enriched solid-phase extracts. There is no common EU-wide agreement on what level of bioassay response in water extracts is acceptable. At present, bioassay results are only benchmarked against each other but not against a consented measure of chemical water quality. The EU environmental quality standards (EQS) differentiate between acceptable and unacceptable surface water concentrations for individual chemicals but cannot capture the thousands of chemicals in water and their biological action as mixtures. We developed a method that reads across from existing EQS and includes additional mixture considerations with the goal that the derived effect-based trigger values (EBT) indicate acceptable risk for complex mixtures as they occur in surface water. Advantages and limitations of various approaches to read across from EQS are discussed and distilled to an algorithm that translates EQS into their corresponding bioanalytical equivalent concentrations (BEQ). The proposed EBT derivation method was applied to 48 in vitro bioassays with 32 of them having sufficient information to yield preliminary EBTs. To assess the practicability and robustness of the proposed approach, we compared the tentative EBTs with observed environmental effects. The proposed method only gives guidance on how to derive EBTs but does not propose final EBTs for implementation. The EBTs for some bioassays such as those for estrogenicity are already mature and could be implemented into regulation in the near future, while for others it will still take a few iterations until we can be confident of the power of the proposed EBTs to differentiate good from poor water quality with respect to chemical contamination. Copyright © 2018 Elsevier B.V. All rights reserved.

Low Serum Bicarbonate Predicts Residual Renal Function Loss in Peritoneal Dialysis Patients.

PubMed

Chang, Tae Ik; Kang, Ea Wha; Kim, Hyung Woo; Ryu, Geun Woo; Park, Cheol Ho; Park, Jung Tak; Yoo, Tae-Hyun; Shin, Sug Kyun; Kang, Shin-Wook; Choi, Kyu Hun; Han, Dae Suk; Han, Seung Hyeok

2015-08-01

Low residual renal function (RRF) and serum bicarbonate are associated with adverse outcomes in peritoneal dialysis (PD) patients. However, a relationship between the 2 has not yet been determined in these patients. Therefore, this study aimed to investigate whether low serum bicarbonate has a deteriorating effect on RRF in PD patients.This prospective observational study included a total of 405 incident patients who started PD between January 2000 and December 2005. We determined risk factors for complete loss of RRF using competing risk methods and evaluated the effects of time-averaged serum bicarbonate (TA-Bic) on the decline of RRF over the first 3 years of dialysis treatment using generalized linear mixed models.During the first 3 years of dialysis, 95 (23.5%) patients became anuric. The mean time until patients became anuric was 20.8 ± 9.0 months. After adjusting for multiple potentially confounding covariates, an increase in TA-Bic level was associated with a significantly decreased risk of loss of RRF (hazard ratio per 1 mEq/L increase, 0.84; 0.75-0.93; P = 0.002), and in comparison to TA-Bic ≥ 24 mEq/L, TA-Bic < 24 mEq/L conferred a 2.62-fold higher risk of becoming anuric. Furthermore, the rate of RRF decline estimated by generalized linear mixed models was significantly greater in patients with TA-Bic < 24 mEq/L compared with those with TA-Bic ≥ 24 mEq/L (-0.16 vs -0.11 mL/min/mo/1.73 m, P < 0.001).In this study, a clear association was found between low serum bicarbonate and loss of RRF in PD patients. Nevertheless, whether correction of metabolic acidosis for this indication provides additional protection for preserving RRF in these patients is unknown. Future interventional studies should more appropriately address this question.

Nitrogen-Use Efficiency, Nitrous Oxide Emissions, and Cereal Production in Brazil: Current Trends and Forecasts.

PubMed

Pires, Marcel Viana; da Cunha, Dênis Antônio; de Matos Carlos, Sabrina; Costa, Marcos Heil

2015-01-01

The agriculture sector has historically been a major source of greenhouse gas (GHG) emissions into the atmosphere. Although the use of synthetic fertilizers is one of the most common widespread agricultural practices, over-fertilization can lead to negative economic and environmental consequences, such as high production costs, depletion of energy resources, and increased GHG emissions. Here, we provide an analysis to understand the evolution of cereal production and consumption of nitrogen (N) fertilizers in Brazil and to correlate N use efficiency (NUE) with economic and environmental losses as N2O emissions. Our results show that the increased consumption of N fertilizers is associated with a large decrease in NUE in recent years. The CO2 eq. of N2O emissions originating from N fertilization for cereal production were approximately 12 times higher in 2011 than in 1970, indicating that the inefficient use of N fertilizers is directly related to environmental losses. The projected N fertilizer forecasts are 2.09 and 2.37 million ton for 2015 and 2023, respectively. An increase of 0.02% per year in the projected NUE was predicted for the same time period. However, decreases in the projected CO2 eq. emissions for future years were not predicted. In a hypothetical scenario, a 2.39% increase in cereal NUE would lead to $ 21 million savings in N fertilizer costs. Thus, increases in NUE rates would lead not only to agronomic and environmental benefits but also to economic improvement.

Pyrolysis and gasification of meat-and-bone-meal: Energy balance and GHG accounting

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

Cascarosa, Esther; Boldrin, Alessio, E-mail: aleb@env.dtu.dk; Astrup, Thomas

Highlights: • GHG savings are in the order of 600–1000 kg CO{sub 2}-eq. per Mg of MBM treated. • Energy recovery differed in terms of energy products and efficiencies. • The results were largely determined by use of the products for energy purposes. - Abstract: Meat-and-bone-meal (MBM) produced from animal waste has become an increasingly important residual fraction needing management. As biodegradable waste is routed away from landfills, thermo-chemical treatments of MBM are considered promising solution for the future. Pyrolysis and gasification of MBM were assessed based on data from three experimental lab and pilot-scale plants. Energy balances were establishedmore » for the three technologies, providing different outcomes for energy recovery: bio-oil was the main product for the pyrolysis system, while syngas and a solid fraction of biochar were the main products in the gasification system. These products can be used – eventually after upgrading – for energy production, thereby offsetting energy production elsewhere in the system. Greenhouse gases (GHG) accounting of the technologies showed that all three options provided overall GHG savings in the order of 600–1000 kg CO{sub 2}-eq. per Mg of MBM treated, mainly as a consequence of avoided fossil fuel consumption in the energy sector. Local conditions influencing the environmental performance of the three systems were identified, together with critical factors to be considered during decision-making regarding MBM management.« less

Nitrogen-Use Efficiency, Nitrous Oxide Emissions, and Cereal Production in Brazil: Current Trends and Forecasts

PubMed Central

Pires, Marcel Viana; da Cunha, Dênis Antônio; de Matos Carlos, Sabrina; Costa, Marcos Heil

2015-01-01

The agriculture sector has historically been a major source of greenhouse gas (GHG) emissions into the atmosphere. Although the use of synthetic fertilizers is one of the most common widespread agricultural practices, over-fertilization can lead to negative economic and environmental consequences, such as high production costs, depletion of energy resources, and increased GHG emissions. Here, we provide an analysis to understand the evolution of cereal production and consumption of nitrogen (N) fertilizers in Brazil and to correlate N use efficiency (NUE) with economic and environmental losses as N2O emissions. Our results show that the increased consumption of N fertilizers is associated with a large decrease in NUE in recent years. The CO2 eq. of N2O emissions originating from N fertilization for cereal production were approximately 12 times higher in 2011 than in 1970, indicating that the inefficient use of N fertilizers is directly related to environmental losses. The projected N fertilizer forecasts are 2.09 and 2.37 million ton for 2015 and 2023, respectively. An increase of 0.02% per year in the projected NUE was predicted for the same time period. However, decreases in the projected CO2 eq. emissions for future years were not predicted. In a hypothetical scenario, a 2.39% increase in cereal NUE would lead to $ 21 million savings in N fertilizer costs. Thus, increases in NUE rates would lead not only to agronomic and environmental benefits but also to economic improvement. PMID:26252377

Cost-effectiveness of a one-year coaching program for healthy physical activity in early rheumatoid arthritis.

PubMed

Brodin, Nina; Lohela-Karlsson, Malin; Swärdh, Emma; Opava, Christina H

2015-01-01

To describe cost-effectiveness of the Physical Activity in Rheumatoid Arthritis (PARA) study intervention. Costs were collected and estimated retrospectively. Cost-effectiveness was calculated based on the intervention cost per patient with respect to change in health status (EuroQol global visual analog scale--EQ-VAS and EuroQol--EQ-5D) and activity limitation (Health assessment questionnaire - HAQ) using cost-effectiveness- and cost-minimization analyses. Total cost of the one-year intervention program was estimated to be €67 317 or €716 per participant. Estimated difference in total societal cost between the intervention (IG) and control (CG) was €580 per participant. Incremental cost-effectiveness ratio (ICER) for one point (1/100) of improvement in EQ-VAS was estimated to be €116. By offering the intervention to more affected participants in the IG compared to less affected participants, 15.5 extra points of improvement in EQ-VAS and 0.13 points of improvement on HAQ were gained at the same cost. "Ordinary physiotherapy" was most cost-effective with regard to EQ-5D. The intervention resulted in improved effect in health status for the IG with a cost of €116 per extra point in VAS. The intervention was cost-effective if targeted towards a subgroup of more affected patients when evaluating the effect using VAS and HAQ. The physical activity coaching intervention resulted in an improved effect on VAS for the intervention group, to a higher cost. In order to maximize cost-effectiveness, this type of physical activity coaching intervention should be targeted towards patients largely affected by their RA. The intervention is cost-effective from the patients' point of view, but not from that of the general population.

Estimating greenhouse gas emissions at the soil-atmosphere interface in forested watersheds of the US Northeast.

PubMed

Gomez, Joshua; Vidon, Philippe; Gross, Jordan; Beier, Colin; Caputo, Jesse; Mitchell, Myron

2016-05-01

Although anthropogenic emissions of greenhouse gases (GHG: CO2, CH4, N2O) are unequivocally tied to climate change, natural systems such as forests have the potential to affect GHG concentration in the atmosphere. Our study reports GHG emissions as CO2, CH4, N2O, and CO2eq fluxes across a range of landscape hydrogeomorphic classes (wetlands, riparian areas, lower hillslopes, upper hillslopes) in a forested watershed of the Northeastern USA and assesses the usability of the topographic wetness index (TWI) as a tool to identify distinct landscape geomorphic classes to aid in the development of GHG budgets at the soil atmosphere interface at the watershed scale. Wetlands were hot spots of GHG production (in CO2eq) in the landscape owing to large CH4 emission. However, on an areal basis, the lower hillslope class had the greatest influence on the net watershed CO2eq efflux, mainly because it encompassed the largest proportion of the study watershed (54 %) and had high CO2 fluxes relative to other land classes. On an annual basis, summer, fall, winter, and spring accounted for 40, 27, 9, and 24 % of total CO2eq emissions, respectively. When compared to other approaches (e.g., random or systematic sampling design), the TWI landscape classification method was successful in identifying dominant landscape hydrogeomorphic classes and offered the possibility of systematically accounting for small areas of the watershed (e.g., wetlands) that have a disproportionate effect on total GHG emissions. Overall, results indicate that soil CO2eq efflux in the Archer Creek Watershed may exceed C uptake by live trees under current conditions.

Bolus fluid therapy and sodium homeostasis in paediatric gastroenteritis.

PubMed

Freedman, Stephen B; Geary, Denis F

2013-03-01

The study aims to assess the risk of developing hyponatraemia when large-volume bolus fluid rehydration therapy is administered. We conducted a prospective randomised study in a tertiary-care centre emergency department. Participants included children with gastroenteritis and dehydration requiring intravenous rehydration. They were randomised to receive 60 mL/kg (large) or 20 mL/kg (standard) 0.9% saline bolus followed by maintenance 0.9% saline for 3 h. Biochemical tests were performed at baseline and 4 h. The primary outcome measure was the development of hyponatraemia at 4 h. Secondary outcome measures were (i) change in sodium relative to baseline value; (ii) magnitude of decrease among those who experienced a decrease; (iii) risk of hypernatraemia; (iv) correlations between urine parameters and hyponatraemia; and (v) fluid overload. Eighty-four of 224 (38%) participants were hyponatraemic at baseline. At 4 h, 22% (48/217) had a dysnatraemia, and similar numbers of children were hyponatraemic in both groups: large (23% (26/112)) versus standard (21% (22/105)) (P = 0.69). Among initially hyponatraemic children, 63% (30/48) who received large-volume rehydration and 44% (15/34) of those administered standard rehydration were isonatraemic at 4 h (P = 0.10). Overall, children who received 60 mL/kg experienced a larger mean increase (1.6 ± 2.4 mEq/L vs. 0.9 ± 2.2 mEq/L; P = 0.04) and were less likely to experience a sodium decrease of ≥2 mEq/L (8/112 vs. 17/105; P = 0.04) than those administered 20 mL/kg. Large-volume bolus rehydration therapy with 0.9% saline is safe. It does not promote the development of hyponatraemia over the short term, but hastens the resolution of baseline hyponatraemia. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Disturbed mouse circadian rhythm before the Kobe EQ in 1995

NASA Astrophysics Data System (ADS)

Yokoi, Sayoko

2013-04-01

Legends of macro-anomalies before large earthquakes have been passed down for generations in Asia. Most of the statements on earthquake precursors are considered unreliable afterthoughts by traditional scientists. However, disturbed biological rhythms in mice were observed before the Kobe EQ in 1995 (Yokoi et al, 2003). The records of unusual mouse behavior before the earthquake were obtained to study biological clock at Institute for Protein Research, Osaka University. It is clarified that the disturbance was very rare phenomena statistically. Similar phenomenon was observed before the Wenchuan earthquake in 2008, too (Li et al, 2009). In the presentation, I will discuss the phenomena as one example of preseismic unusual animal behaviors.

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.

An exploration of differences between Japan and two European countries in the self-reporting and valuation of pain and discomfort on the EQ-5D.

PubMed

Feng, Yan; Herdman, Mike; van Nooten, Floortje; Cleeland, Charles; Parkin, David; Ikeda, Shunya; Igarashi, Ataru; Devlin, Nancy J

2017-08-01

To investigate the systematic differences in the self-reporting and valuation of overall health and, in particular, pain/discomfort between three countries (England/UK, Japan, and Spain) on the EQ-5D. Existing datasets were used to explore differences in responses on the EQ-5D descriptive system between Japan (3L and 5L), the UK (3L), England (5L), and Spain (5L), particularly on the dimension of pain/discomfort. The role of different EQ dimensions in determining self-reported overall health scores for the EuroQol visual analog scale (EQ-VAS) was investigated using ordinary least squares regression. Time trade-off (TTO) results from Japanese and UK respondents for the EQ-5D-3L as well as Japanese and English respondents for the EQ-5D-5L were compared using t tests. For the EQ-5D-3L, a higher percentage of respondents in Japan than in the UK reported 'no pain/discomfort' (81.6 vs 67.0%, respectively); for the EQ-5D-5L, the proportions were 79.2% in Spain, 73.2% in Japan, and 63-64% in England, after adjusting for age differences in samples. The 'pain/discomfort' dimension had the largest impact on respondents' self-reported EQ-VAS only for EQ-5D-3L in Japan. Using the EQ-5D-3L, Japanese respondents were considerably less willing to trade off time to avoid pain/discomfort than the UK respondents; for example, moving from health state, 11121 (some problems with pain/discomfort) to 11131 (extreme pain/discomfort) represented a decrement of 0.65 on the observed TTO value in the UK compared with 0.15 in Japan. Using the EQ-5D-5L, Japanese respondents were also less willing to trade off time to avoid pain/discomfort than respondents in England; however, the difference in values was much smaller than that observed using EQ-5D-3L data. This study provides evidence of between-country differences in the self-reporting and valuation of health, including pain/discomfort, when using EQ-5D in general population samples. The results suggest a need for caution when comparing or aggregating EQ-5D self-reported data in multi-country studies.

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).

Using an intense laser beam in interaction with muon/electron beam to probe the noncommutative QED

NASA Astrophysics Data System (ADS)

Tizchang, S.; Batebi, S.; Haghighat, M.; Mohammadi, R.

2017-02-01

It is known that the linearly polarized photons can partly transform to circularly polarized ones via forward Compton scattering in a background such as the external magnetic field or noncommutative space time. Based on this fact we explore the effects of the NC-background on the scattering of a linearly polarized laser beam from an intense beam of charged leptons. We show that for a muon/electron beam flux {overline{ɛ}}_{μ, e}˜ 1{0}^{12}/{10}^{10} TeV cm-2 sec-1 and a linearly polarized laser beam with energy k 0 ˜1 eV and average power {overline{P}}_{laser}˜eq 1{0}^3 KW, the generation rate of circularly polarized photons is about R V ˜ 104 /sec for noncommutative energy scale ΛNC ˜ 10 TeV. This is fairly large and can grow for more intense beams in near future.

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.

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.

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.

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.

Environmental impacts of residual Municipal Solid Waste incineration: A comparison of 110 French incinerators using a life cycle approach

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

Beylot, Antoine, E-mail: a.beylot@brgm.fr; Villeneuve, Jacques

Highlights: • 110 French incinerators are compared with LCA based on plant-specific data. • Environmental impacts vary as a function of plants energy recovery and NO{sub x} emissions. • E.g. climate change impact ranges from −58 to 408 kg CO{sub 2}-eq/tonne of residual MSW. • Implications for LCA of waste management in a decision-making process are detailed. - Abstract: Incineration is the main option for residual Municipal Solid Waste treatment in France. This study compares the environmental performances of 110 French incinerators (i.e. 85% of the total number of plants currently in activity in France) in a Life Cycle Assessmentmore » perspective, considering 5 non-toxic impact categories: climate change, photochemical oxidant formation, particulate matter formation, terrestrial acidification and marine eutrophication. Mean, median and lower/upper impact potentials are determined considering the incineration of 1 tonne of French residual Municipal Solid Waste. The results highlight the relatively large variability of the impact potentials as a function of the plant technical performances. In particular, the climate change impact potential of the incineration of 1 tonne of waste ranges from a benefit of −58 kg CO{sub 2}-eq to a relatively large burden of 408 kg CO{sub 2}-eq, with 294 kg CO{sub 2}-eq as the average impact. Two main plant-specific parameters drive the impact potentials regarding the 5 non-toxic impact categories under study: the energy recovery and delivery rate and the NO{sub x} process-specific emissions. The variability of the impact potentials as a function of incinerator characteristics therefore calls for the use of site-specific data when required by the LCA goal and scope definition phase, in particular when the study focuses on a specific incinerator or on a local waste management plan, and when these data are available.« less

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 EQ-5D-5L health status questionnaire in COPD: validity, responsiveness and minimum important difference.

PubMed

Nolan, Claire M; Longworth, Louise; Lord, Joanne; Canavan, Jane L; Jones, Sarah E; Kon, Samantha S C; Man, William D-C

2016-06-01

The EQ-5D, a generic health status questionnaire that is widely used in health economic evaluation, was recently expanded to the EQ-5D-5L to address criticisms of unresponsiveness and ceiling effect. To describe the validity, responsiveness and minimum important difference of the EQ-5D-5L in COPD. Study 1: The validity of the EQ-5D-5L utility index and visual analogue scale (EQ-VAS) was compared with four established disease-specific health status questionnaires and other measures of disease severity in 616 stable outpatients with COPD. Study 2: The EQ-5D-5L utility index and EQ-VAS were measured in 324 patients with COPD before and after 8 weeks of pulmonary rehabilitation. Distribution and anchor-based approaches were used to estimate the minimum important difference. There were moderate-to-strong correlations between utility index and EQ-VAS with disease-specific questionnaires (Pearson's r=0.47-0.72). A ceiling effect was seen in 7% and 2.6% of utility index and EQ-VAS. Utility index decreased (worsening health status) with indices of worsening disease severity. With rehabilitation, mean (95% CI) changes in utility index and EQ-VAS were 0.065 (0.047 to 0.083) and 8.6 (6.5 to 10.7), respectively, with standardised response means of 0.39 and 0.44. The mean (range) anchor estimates of the minimum important difference for utility index and EQ-VAS were 0.051 (0.037 to 0.063) and 6.9 (6.5 to 8.0), respectively. The EQ-5D-5L is a valid and responsive measure of health status in COPD and may provide useful additional cost-effectiveness data in clinical trials. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

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.

Geochemistry and source waters of rock glacier outflow, Colorado Front Range

USGS Publications Warehouse

Williams, M.W.; Knauf, M.; Caine, N.; Liu, F.; Verplanck, P.L.

2006-01-01

We characterize the seasonal variation in the geochemical and isotopic content of the outflow of the Green Lake 5 rock glacier (RG5), located in the Green Lakes Valley of the Colorado Front Range, USA. Between June and August, the geochemical content of rock glacier outflow does not appear to differ substantially from that of other surface waters in the Green Lakes Valley. Thus, for this alpine ecosystem at this time of year there does not appear to be large differences in water quality among rock glacier outflow, glacier and blockslope discharge, and discharge from small alpine catchments. However, in September concentrations of Mg2+ in the outflow of the rock glacier increased to more than 900 ??eq L-1 compared to values of less than 40 ??eq L-1 at all the other sites, concentrations of Ca2+ were greater than 4,000 ??eq L-1 compared to maximum values of less than 200 ??eq L-1 at all other sites, and concentrations of SO42- reached 7,000 ??eq L-1, compared to maximum concentrations below 120 ??eq L-1 at the other sites. Inverse geochemical modelling suggests that dissolution of pyrite, epidote, chlorite and minor calcite as well as the precipitation of silica and goethite best explain these elevated concentrations of solutes in the outflow of the rock glacier. Three component hydrograph separation using end-member mixing analysis shows that melted snow comprised an average of 30% of RG5 outflow, soil water 32%, and base flow 38%. Snow was the dominant source water in June, soil water was the dominant water source in July, and base flow was the dominant source in September. Enrichment of ?? 18O from - 10??? in the outflow of the rock glacier compared to -20??? in snow and enrichment of deuterium excess from +17.5??? in rock glacier outflow compared to +11??? in snow, suggests that melt of internal ice that had undergone multiple melt/freeze episodes was the dominant source of base flow. Copyright ?? 2005 John Wiley & Sons, Ltd.

Water and Land Use Efficiency in Current and Potential Future US Corn and Brazilian Sugarcane Ethanol Systems

NASA Astrophysics Data System (ADS)

Warner, E. S.; Zhang, Y.; Newmark, R. L.

2012-12-01

Biofuels represent an opportunity for domestic fuel production from renewable energy sources with potential environmental and social benefits such as reducing greenhouse gas (GHG) and promoting rural development. However, as demand for biofuel continues to increase worldwide, concerns about land competition between food and fuel, excessive water usage and other unintended environmental consequences have grown. Through a comparative study between US corn ethanol and Brazilian sugarcane ethanol, we examine the energy, land, water and GHG performance of the two largest industrial fuel ethanol production systems in the world. Our comparisons include current and potential future systems with improved agronomic practices, crop yields, ethanol conversion processes, and utilization of agricultural residues. Our results suggest that the average water footprints of US corn ethanol and Brazilian sugarcane ethanol are fairly close (108 and 110 m3/GJ of ethanol, respectively) while the variations can range from 50 to 250 m3/GJ for sugarcane ethanol and 50 to380 m3/GJ for corn ethanol. Results emphasize the need to examine the water footprint within the context of local and regional climatic variability, water availability, competing uses (e.g. agricultural, industrial, and municipal water needs) and other ecosystem constraints. Research is under way (at the National Renewable Energy Laboratory and other institutions) to develop models to analyze water supply and demand at the watershed-scale for current and future biomass production, and to understand the tradeoffs among water supply, demand and quality due to more intensive agricultural practices and expansion of biofuels. Land use efficiency metrics, with regards to life cycle GHG emissions (without land use change) savings through gasoline displacement with ethanol, illustrate the progression of the biofuel industry and the importance of maximizing bioenergy production by utilizing both the crops and the residues. A recent average sugarcane ethanol system producing ethanol and electricity can save about 13 Mg CO2eq/ha of land compared to 12 in the early 2000s, while a recent average corn ethanol system saves about 6.2 Mg CO2eq/ha compared to near zero GHG savings in the early 2000s. The net energy balance (i.e., energy produced minus energy consumed) per ha for a recent average sugarcane ethanol system producing both ethanol and electricity is about 160 GJ/ha compared to 140 GJ/ha in early 2000s, while the recent average corn ethanol system achieves a net energy production of about 90 GJ/ha compares to only 30 GJ/ha in the early 2000s. The land use efficiency of corn and sugarcane ethanol systems, especially future systems, can vary depending on factors such as the assumed technologies, the suite of co-products produced, field practices, and technological learning. For example, projected future (2020) advanced sugarcane ethanol systems could save 22 Mg CO2eq/ha while an advanced corn ethanol system using integrated gasification of corn stover for electricity production could save 9.3Mg CO2eq/ha. Future advanced sugarcane ethanol systems could produce 210 GJ of net energy/ha while an advanced corn ethanol system using integrated gasification of corn stover for electricity production could achieve 110 GJ/ha.

Monitoring Seismic Velocity Change to Explore the Earthquake Seismogenic Structures

NASA Astrophysics Data System (ADS)

Liao, C. F.; Wen, S.; Chen, C.

2017-12-01

Studying spatial-temporal variations of subsurface velocity structures is still a challenge work, but it can provide important information not only on geometry of a fault, but also the rheology change induced from the strong earthquake. In 1999, a disastrous Chi-Chi earthquake (Mw7.6; Chi-Chi EQ) occurred in central Taiwan and caused great impacts on Taiwan's society. Therefore, the major objective of this research is to investigate whether the rheology change of fault can be associated with seismogenic process before strong earthquake. In addition, after the strike of the Chi-Chi EQ, whether the subsurface velocity structure resumes to its steady state is another issue in this study. Therefore, for the above purpose, we have applied a 3D tomographic technique to obtain P- and S-wave velocity structures in central Taiwan using travel time data provided by the Central Weather Bureau (CWB). One major advantage of this method is that we can include out-of-network data to improve the resolution of velocity structures at deeper depths in our study area. The results show that the temporal variations of Vp are less significant than Vs (or Vp/Vs ratio), and Vp is not prominent perturbed before and after the occurrence of the Chi-Chi EQ. However, the Vs (or Vp/Vs ratio) structure in the source area demonstrates significant spatial-temporal difference before and after the mainshock. From the results, before the mainshock, Vs began to decrease (Vp/Vs ratio was increased as well) at the hanging wall of Chelungpu fault, which may be induced by the increasing density of microcracks and fluid. But in the vicinities of Chi-Chi Earthquake's source area, Vs was increasing (Vp/Vs ratio was also decreased). This phenomenon may be owing to the closing of cracks or migration of fluid. Due to the different physical characteristics around the source area, strong earthquake may be easily nucleated at the junctional zone. Our findings suggest that continuously monitoring the Vp and Vs (or Vp/Vs ratio) structures in high seismic potential zones is an important task which can lead to reduce seismic hazard for a future large earthquake.

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.

Combat Synchronization Analysis

DTIC Science & Technology

1993-12-01

ACTIVITY, ,ATR.I8(4) .EQ3, ZAGO ; ACTIVITY,,ATRIB(4) .EQ.4,ZAGP; ACTIVITY, ,ATRIB(4) .EQ.5,ZAGQ; ACTIVITY, ,ATRIB (4) .EQ. 6, ZAGR; COLCT,INT(l),OILOST...CDR ORD; ACTIVITY, ...TERM; ZAGO COLCT,INT(1),OILOST DETECTS; ACTIVITY, ...TERM; ZAGP COLCT, IN? (1),OILOST FRAGO; ACTIVITY .. ,TERM; ZAGO COLCT, IN

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.

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.

Minimal clinically important improvement (MCII) and patient-acceptable symptom state (PASS) in total hip arthroplasty (THA) patients 1 year postoperatively

PubMed Central

Paulsen, Aksel

2014-01-01

Background and purpose The increased use of patient-reported outcomes (PROs) in orthopedics requires data on estimated minimal clinically important improvements (MCIIs) and patient-acceptable symptom states (PASSs). We wanted to find cut-points corresponding to minimal clinically important PRO change score and the acceptable postoperative PRO score, by estimating MCII and PASS 1 year after total hip arthroplasty (THA) for the Hip Dysfunction and Osteoarthritis Outcome Score (HOOS) and the EQ-5D. Patients and methods THA patients from 16 different departments received 2 PROs and additional questions preoperatively and 1 year postoperatively. The PROs included were the HOOS subscales pain (HOOS Pain), physical function short form (HOOS-PS), and hip-related quality of life (HOOS QoL), and the EQ-5D. MCII and PASS were estimated using multiple anchor-based approaches. Results Of 1,837 patients available, 1,335 answered the preoperative PROs, and 1,288 of them answered the 1-year follow-up. The MCIIs and PASSs were estimated to be: 24 and 91 (HOOS Pain), 23 and 88 (HOOS-PS), 17 and 83 (HOOS QoL), 0.31 and 0.92 (EQ-5D Index), and 23 and 85 (EQ-VAS), respectively. MCIIs corresponded to a 38–55% improvement from mean baseline PRO score and PASSs corresponded to absolute follow-up scores of 57–91% of the maximum score in THA patients 1 year after surgery. Interpretation This study improves the interpretability of PRO scores. The different estimation approaches presented may serve as a guide for future MCII and PASS estimations in other contexts. The cutoff points may serve as reference values in registry settings. PMID:24286564

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.

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.

Quality of life in older individuals with joint contractures in geriatric care settings.

PubMed

Heise, Marco; Müller, Martin; Fischer, Uli; Grill, Eva

2016-09-01

The purpose of this study was to analyze the association between functioning and disability and quality of life (QoL) in older individuals with joint contractures in the geriatric care setting. More specifically, this study aimed to identify determinants of QoL out of a defined set of contracture-related categories of the International Classification of Functioning, Disability and Health (ICF). Participants for this multicenter cross-sectional survey were recruited from acute geriatric rehabilitation hospitals, nursing homes, and community nursing facilities in Germany between February and October 2013. QoL was assessed using the validated German version of the EQ-5D index score and the EQ-5D visual analog scale (VAS). Manual and automatic variable selection methods were used to identify the most relevant variables out of 125 contracture-related ICF categories. A total of 241 eligible participants (34.9 % male, mean age 80.1 years) were included. The final models contained 14 ICF categories as predictors of the EQ-5D index score and 15 categories as predictors of the EQ-5D VAS. The statistically significant ICF categories from both models were 'muscle power functions (b730),' 'memory functions (b144),' 'taking care of plants (d6505),' 'recreation and leisure (d920),' 'religion and spirituality (d930),' 'drugs (e1101),' and 'products and technology for personal use in daily living (e115).' We identified the most relevant ICF categories for older individuals with joint contractures and their health-related quality of life. These items describe potential determinants of QoL which may provide the basis for future health interventions aiming to improve QoL for the patients with joint contractures.

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

MSW Transducers

DTIC Science & Technology

1988-11-01

6 - 6 ) and ( 6 - 7 ), with the notation of Figure ( 6 -la), the integral across the nth strip is given by Eq. ( 6 -8). (n-1) p+a/2... calculation . For a finite number of strips, the array is simply truncated without altering the fields. The theoretical expression for hx is given in Eq. ( 6 ... given by Eq. (12) in Reference 2. It is given in this report by Eq. ( 7 -23) or Eq. ( 6 -19). The real average power going into MSW is now a function of z.

Environmental impacts of residual municipal solid waste incineration: a comparison of 110 French incinerators using a life cycle approach.

PubMed

Beylot, Antoine; Villeneuve, Jacques

2013-12-01

Incineration is the main option for residual Municipal Solid Waste treatment in France. This study compares the environmental performances of 110 French incinerators (i.e., 85% of the total number of plants currently in activity in France) in a Life Cycle Assessment perspective, considering 5 non-toxic impact categories: climate change, photochemical oxidant formation, particulate matter formation, terrestrial acidification and marine eutrophication. Mean, median and lower/upper impact potentials are determined considering the incineration of 1 tonne of French residual Municipal Solid Waste. The results highlight the relatively large variability of the impact potentials as a function of the plant technical performances. In particular, the climate change impact potential of the incineration of 1 tonne of waste ranges from a benefit of -58 kg CO2-eq to a relatively large burden of 408 kg CO2-eq, with 294 kg CO2-eq as the average impact. Two main plant-specific parameters drive the impact potentials regarding the 5 non-toxic impact categories under study: the energy recovery and delivery rate and the NOx process-specific emissions. The variability of the impact potentials as a function of incinerator characteristics therefore calls for the use of site-specific data when required by the LCA goal and scope definition phase, in particular when the study focuses on a specific incinerator or on a local waste management plan, and when these data are available. Copyright © 2013 Elsevier Ltd. All rights reserved.

Experimental Rhodococcus equi and equine infectious anemia virus DNA vaccination in adult and neonatal horses: Effect of IL-12, dose, and route

PubMed Central

Mealey, R.H.; Stone, D.M.; Hines, M.T.; Alperin, D.C.; Littke, M.H.; Leib, S.R.; Leach, S.E.; Hines, S.A.

2012-01-01

Improving the ability of DNA-based vaccines to induce potent Type1/Th1 responses against intracellular pathogens in large outbred species is essential. Rhodoccocus equi and equine infectious anemia virus (EIAV) are two naturally occurring equine pathogens that also serve as important large animal models of neonatal immunity and lentiviral immune control. Neonates present a unique challenge for immunization due to their diminished immunologic capabilities and apparent Th2 bias. In an effort to augment R. equi- and EIAV-specific Th1 responses induced by DNA vaccination, we hypothesized that a dual promoter plasmid encoding recombinant equine IL-12 (rEqIL-12) would function as a molecular adjuvant. In adult horses, DNA vaccines induced R. equi- and EIAV-specific antibody and lymphoproliferative responses, and EIAV-specific CTL and tetramer-positive CD8+ T lymphocytes. These responses were not enhanced by the rEqIL-12 plasmid. In neonatal foals, DNA immunization induced EIAV-specific antibody and lymphoproliferative responses, but not CTL. The R. equi vapA vaccine was poorly immunogenic in foals even when co-administered with the IL-12 plasmid. It was concluded that DNA immunization was capable of inducing Th1 responses in horses; dose and route were significant variables, but rEqIL-12 was not an effective molecular adjuvant. Additional work is needed to optimize DNA vaccine-induced Th1 responses in horses, especially in neonates. PMID:17889970

Ion Fluxes and Short-Circuit Current in Internally Perfused Cells of Valonia ventricosa

PubMed Central

Gutknecht, John

1967-01-01

Ion transport in the giant celled marine alga, Valonia ventricosa, was studied during internal perfusion and short-circuiting of the vacuole potential. The perfusing and bathing solutions were similar to natural Valonia sap and contained the following concentrations of major ions: Na 51, K 618, and Cl 652 mM. The average short-circuit current (I sc) was 97 pEq/cm2 sec (inward positive current), and the average open-circuit potential difference (PD) was 74 mv (vacuole positive to external solution). Perfused and short-circuited cells showed a small net influx of Na (2.0 pEq/cm2 sec) and large net influxes of K (80 pEq/cm2 sec) and Cl (50 pEq/cm2 sec). Unidirectional K influx was proportional to I sc, but more than one-half of the I sc remained unaccounted for. Both the I sc and PD were partly light-dependent, declining rapidly during the first 1–2 min of darkness. Ouabain (5 x 10-4 M) had little effect on the influx of Na or K and had no effect on I inf or PD. Fluid was absorbed at a rate of about 93 pliter/cm2 sec. Reversing the direction of fluid movement by adding mannitol to the outside solution had little effect on ion movements. The ionic and electrical properties of normal and perfused cells of Valonia are compared. PMID:6050968

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.

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.

Acidification and Prognosis for Future Recovery of Acid-Sensitive Streams in the Southern Blue Ridge Province

Treesearch

Timothy Sullivan; Bernard Cosby; William Jackson; Kai Snyder; Alan Herlihy

2011-01-01

This study applied the Model of Acidification of Groundwater in Catchments (MAGIC) to estimate the sensitivity of 66 watersheds in the Southern Blue Ridge Province of the Southern Appalachian Mountains, United States, to changes in atmospheric sulfur (S) deposition. MAGIC predicted that stream acid neutralizing capacity (ANC) values were above 20 μeq/L in all modeled...

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.

A Head-to-Head Comparison of UK SF-6D and Thai and UK EQ-5D-5L Value Sets in Thai Patients with Chronic Diseases.

PubMed

Sakthong, Phantipa; Munpan, Wipaporn

2017-10-01

Little was known about the head-to-head comparison of psychometric properties between SF-6D and EQ-5D-5L or the different value sets of EQ-5D-5L. Therefore, this study set out to compare the psychometric properties including agreement, convergent, and known-group validity between the SF-6D and the EQ-5D-5L using the real value sets from Thailand and the UK in patients with chronic diseases. 356 adults taking a medication for at least 3 months were identified from a university hospital in Bangkok, Thailand, between July 2014 and March 2015. Agreement was assessed by intraclass correlation coefficients (ICCs) and Bland-Altman plots. Convergent validity was evaluated using Spearman's rank correlation coefficients between SF-6D and EQ-5D-5L and EQ-VAS and SF-12v2. For known-groups validity, the Mann-Whitney U test and Kruskal-Wallis test were used to examine the associations between SF-6D and EQ-5D-5L and patient characteristics. Agreements between the SF-6D and the EQ-5D-5L using Thai and UK value sets were fair, with ICCs of 0.45 and 0.49, respectively. Bland-Altman plots showed that the majority of the SF-6D index scores were lower than the EQ-5D-5L index scores. Both the EQ-5D-5L value sets were more related to the EQ-VAS and physical health, while the SF-6D was more associated with mental health. Both EQ-5D-5L value sets were more sensitive than the SF-6D in discriminating patients with different levels of more known groups except for adverse drug reactions. The SF-6D and both EQ-5D-5L value sets appeared to be valid but sensitive to different outcomes in Thai patients with chronic diseases.

Quality of cucumbers commercially fermented in calcium chloride brine without sodium salts

USDA-ARS?s Scientific Manuscript database

Commercial cucumber fermentation produces large volumes of salty wastewater. This study evaluated the quality of fermented cucumbers produced commercially using an alternative calcium chloride brining process. Fermentation conducted in calcium brines (0.1M calcium chloride, 6mM potassium sorbate, eq...

Miniature Rotorcraft Flight Control Stabilization System

DTIC Science & Technology

2008-05-30

The first algorithm is based on the well known QUEST algorithm used for spacecraft and satellites. Due to large vibration in sensors a pseudo...for spacecraft and satellites. Due to large vibration in sensors a pseudo-measurement is developed from gyroscope measurements and rotational...using any valid set of orientation map. Note, in Eq. (6) Euler angles were used to describe . A common alternative to Euler angles is a quaternion

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.

A Methodology for Integrated, Multiregional Life Cycle Assessment Scenarios under Large-Scale Technological Change.

PubMed

Gibon, Thomas; Wood, Richard; Arvesen, Anders; Bergesen, Joseph D; Suh, Sangwon; Hertwich, Edgar G

2015-09-15

Climate change mitigation demands large-scale technological change on a global level and, if successfully implemented, will significantly affect how products and services are produced and consumed. In order to anticipate the life cycle environmental impacts of products under climate mitigation scenarios, we present the modeling framework of an integrated hybrid life cycle assessment model covering nine world regions. Life cycle assessment databases and multiregional input-output tables are adapted using forecasted changes in technology and resources up to 2050 under a 2 °C scenario. We call the result of this modeling "technology hybridized environmental-economic model with integrated scenarios" (THEMIS). As a case study, we apply THEMIS in an integrated environmental assessment of concentrating solar power. Life-cycle greenhouse gas emissions for this plant range from 33 to 95 g CO2 eq./kWh across different world regions in 2010, falling to 30-87 g CO2 eq./kWh in 2050. Using regional life cycle data yields insightful results. More generally, these results also highlight the need for systematic life cycle frameworks that capture the actual consequences and feedback effects of large-scale policies in the long term.

Graft patency is associated with higher health-related quality of life after coronary artery bypass surgery.

PubMed

Samano, Ninos; Bodin, Lennart; Karlsson, Jan; Geijer, Håkan; Arbeus, Mikael; Souza, Domingos

2017-03-01

The objective of this study was to investigate whether graft patency was associated with higher health-related quality of life in coronary artery bypass grafting patients and to compare this study with the general Swedish population. Patients were included from 3 randomized trials and 1 prospective cohort trial. The generic health-related quality of life instrument, EQ-5D (VAS and index) was used. Graft patency was assessed with computed tomography angiography. Patients were divided into 2 groups according to the number of occluded distal anastomosis: Group I with no to 1 occlusion ( n  = 209) and Group II with 2 to 4 occlusions ( n  = 24). Two hundred and thirty-three patients underwent computed tomography angiography at a mean of 7.5 (1-18) years post-operatively. The mean difference in EQ-VAS and EQ-5D index between Groups II and I after model adjustment was -19.8 (95% CI -25.3 to -14.3; P  < 0.001) and -0.13 (95% CI -0.19 to -0.08; P  < 0.001), respectively. The EQ-5D index for the study population was similar compared with the Swedish population, 0.851 and 0.832, respectively, with an effect-size of 0.112 (trivial). The EQ-5D index of the study population was higher compared with the ischemic heart disease group in the Swedish population, 0.851 vs 0.60, with an effect-size of 0.999 (large). Graft patency was associated with higher health-related quality of life in coronary artery bypass patients. This patient group reported similar function and wellbeing compared to the general Swedish population and better health status than those in the same disease group in the general population. Clinicaltrials.gov: NCT02547194 and the Research and Development registry in Sweden: 167861. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

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.

Pollutant in palm oil production process.

PubMed

Hosseini, Seyed Ehsan; Abdul Wahid, Mazlan

2015-07-01

Palm oil mill effluent (POME) is a by-product of the palm industry and it releases large amounts of greenhouse gases (GHGs). Water systems are also contaminated by POME if it is released into nonstandard ponds or rivers where it endangers the lives of fish and water fowl. In this paper, the environmental bottlenecks faced by palm oil production were investigated by analyzing the data collected from wet extraction palm oil mills (POMs) located in Malaysia. Strategies for reducing pollution and technologies for GHG reduction from the wet extraction POMs were also proposed. Average GHG emissions produced from processing 1 ton of crude palm oil (CPO) was 1100 kg CO2eq. This amount can be reduced to 200 kg CO2eq by capturing biogases. The amount of GHG emissions from open ponds could be decreased from 225 to 25 kg CO2eq/MT CPO by covering the ponds. Installation of biogas capturing system can decrease the average of chemical oxygen demand (COD) to about 17,100 mg/L and stabilizing ponds in the final step could decrease COD to 5220 mg/L. Using a biogas capturing system allows for the reduction of COD by 80% and simultaneously using a biogas capturing system and by stabilizing ponds can mitigate COD by 96%. Other ways to reduce the pollution caused by POME, including the installation of wet scrubber vessels and increasing the performance of biogas recovery and biogas upgrading systems, are studied in this paper. Around 0.87 m3 POME is produced per 1 ton palm fruit milled. POME consists of around 2% oil, 2-4% suspended solid, 94-96% water. In palm oil mills, more than 90% of GHGs were emitted from POME. From 1 ton crude palm oil, 1100 kg CO2eq GHGs are generated, which can be reduced to 200 kg CO2eq by installation of biogas capturing equipment.

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.

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.

A prospective study on red blood cell transfusion related hyperkalemia in critically ill patients.

PubMed

Raza, Shahzad; Ali Baig, Mahadi; Chang, Christopher; Dabas, Ridhima; Akhtar, Mallika; Khan, Areej; Nemani, Krishna; Alani, Rahima; Majumder, Omran; Gazizova, Natalya; Biswas, Shaluk; Patel, Priyeshkumar; Al-Hilli, Jaffar A; Shad, Yasar; Berger, Barbara J; Zaman, Mohammad

2015-06-01

Transfusion-associated hyperkalemic cardiac arrest is a serious complication in patients receiving packed red blood cell (PRBC) transfusions. Mortality from hyperkalemia increases with large volumes of PRBC transfusion, increased rate of transfusion, and the use of stored PRBCs. Theoretically, hyperkalemia may be complicated by low cardiac output, acidosis, hyperglycemia, hypocalcemia, and hypothermia. In this study, we focus on transfusion-related hyperkalemia involving only medical intensive care unit (MICU) patients. This prospective observational study focuses on PRBC transfusions among MICU patients greater than 18 years of age. Factors considered during each transfusion included patient's diagnosis, indication for transfusion, medical co-morbidities, acid-base disorders, K(+) levels before and after each PRBC transfusion, age of stored blood, volume and rate of transfusion, and other adverse events. We used Pearson correlation and multivariate analysis for each factor listed above and performed a logistic regression analysis. Between June 2011 and December 2011, 125 patients received a total of 160 units of PRBCs. Median age was 63 years (22 - 92 years). Seventy-one (57%) were females. Sixty-three patients (50%) had metabolic acidosis, 75 (60%) had acute renal failure (ARF), and 12 (10%) had end-stage renal disease (ESRD). Indications for transfusion included septic shock (n = 65, 52%), acute blood loss (n = 25, 20%), non-ST elevation myocardial infarction (NSTEMI) (n = 25, 20%) and preparation for procedures (n = 14, 11%). Baseline K(+) value was 3.9 ± 1.1 mEq/L compared to 4.3 ± 1.2 mEq/L post-transfusion respectively (P = 0.9). During this study period, 4% of patients developed hyperkalemia (K(+) 5.5 mEq/L or above). The mean change of serum potassium in patients receiving transfusion ≥ 12 days old blood was 4.1 ± 0.4 mEq/L compared to 4.8 ± 0.3 mEq/L (mean ± SD) in patients receiving blood 12 days or less old. Sixty-two patients (77.5%) that were transfused stored blood (for more than 12 days) had increased serum K(+); eight (17.7%) patients received blood that was stored for less than 12 days. In both univariate (P = 0.02) and multivariate (P = 0.04) analysis, findings showed that among all factors, transfusion of stored blood was the only factor that affected serum potassium levels (95% CI: 0.32 - 0.91). No difference was found between central and peripheral intravenous access (P = 0.12), acidosis (P = 0.12), ARF (P = 0.6), ESRD (P = 0.5), and multiple transfusions (P = 0.09). One subject developed a sustained cardiac arrest after developing severe hyperkalemia (K(+) = 9.0) following transfusion of seven units of PRBCs. Multivariate logistic regression showed linear correlation between duration of stored blood and serum K(+) (R(2) = 0.889). This study assesses factors that affect K(+) in patients admitted to MICU. Results from the study show that rise in serum K(+) level is more pronounced in patients who receive stored blood (> 12 days). Future studies should focus on the use of altered storage solution, inclusion of potassium absorption filters during transfusion and cautious use of blood warmer in patients requiring massive blood transfusions.

Bayesian nonparametric estimation of EQ-5D utilities for United States using the existing United Kingdom data.

PubMed

Kharroubi, Samer A

2017-10-06

Valuations of health state descriptors such as EQ-5D or SF6D have been conducted in different countries. There is a scope to make use of the results in one country as informative priors to help with the analysis of a study in another, for this to enable better estimation to be obtained in the new country than analyzing its data separately. Data from 2 EQ-5D valuation studies were analyzed using the time trade-off technique, where values for 42 health states were devised from representative samples of the UK and US populations. A Bayesian non-parametric approach has been applied to predict the health utilities of the US population, where the UK results were used as informative priors in the model to improve their estimation. The findings showed that employing additional information from the UK data helped in the production of US utility estimates much more precisely than would have been possible using the US study data alone. It is very plausible that this method would serve useful in countries where the conduction of large evaluation studies is not very feasible.

mRuby, a Bright Monomeric Red Fluorescent Protein for Labeling of Subcellular Structures

PubMed Central

Kredel, Simone; Oswald, Franz; Nienhaus, Karin; Deuschle, Karen; Röcker, Carlheinz; Wolff, Michael; Heilker, Ralf; Nienhaus, G. Ulrich; Wiedenmann, Jörg

2009-01-01

A monomeric variant of the red fluorescent protein eqFP611, mRuby, is described. With excitation and emission maxima at 558 nm and 605 nm, respectively, and a large Stokes shift of 47 nm, mRuby appears particularly useful for imaging applications. The protein shows an exceptional resistance to denaturation at pH extremes. Moreover, mRuby is about ten-fold brighter compared to EGFP when being targeted to the endoplasmic reticulum. The engineering process of eqFP611 revealed that the C-terminal tail of the protein acts as a natural peroxisomal targeting signal (PTS). Using an mRuby variant carrying the eqFP611-PTS, we discovered that ordered inheritance of peroxisomes is widespread during mitosis of different mammalian cell types. The ordered partitioning is realized by the formation of peroxisome clusters around the poles of the mitotic spindle and ensures that equal numbers of the organelle are inherited by the daughter cells. The unique spectral properties make mRuby the marker of choice for a multitude of cell biological applications. Moreover, the use of mRuby has allowed novel insights in the biology of organelles responsible for severe human diseases. PMID:19194514

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.

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.

Life cycle environmental impacts of substituting food wastes for traditional anaerobic digestion feedstocks.

PubMed

Pérez-Camacho, María Natividad; Curry, Robin; Cromie, Thomas

2018-03-01

In this study, life cycle assessment has been used to evaluate life cycle environmental impacts of substituting traditional anaerobic digestion (AD) feedstocks with food wastes. The results have demonstrated the avoided GHG emissions from substituting traditional AD feedstocks with food waste (avoided GHG-eq emissions of 163.33 CO 2 -eq). Additionally, the analysis has included environmental benefits of avoided landfilling of food wastes and digestate use as a substitute for synthetic fertilisers. The analysis of the GHG mitigation benefits of resource management/circular economy policies, namely, the mandating of a ban on the landfilling of food wastes, has demonstrated the very substantial GHG emission reduction that can be achieved by these policy options - 2151.04 kg CO 2 eq per MWh relative to UK Grid. In addition to the reduction in GHG emission, the utilization of food waste for AD instead of landfilling can manage the leakage of nutrients to water resources and eliminate eutrophication impacts which occur, typically as the result of field application. The results emphasise the benefits of using life-cycle thinking to underpin policy development and the implications for this are discussed with a particular focus on the analysis of policy development across the climate, renewable energy, resource management and bioeconomy nexus and recommendations made for future research priorities. Copyright © 2017 Elsevier Ltd. All rights reserved.

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.

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.

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.

Multifractal Detrended Fluctuation Analysis of Self-Potential Field Prior to the M 6.5, October 24, 1993 Earthquake in MÉXICO

NASA Astrophysics Data System (ADS)

Cervantes, F.; González-Trejo, J. I.; Real-Ramírez, C. A.; Hoyos-Reyes, L. F.; Area de Sistemas Computacionales

2013-05-01

In the current literature on seismo electromagnetic, it has been reported many earthquakes which present electromagnetic anomalies as probable precursors of their occurrences. Although this methodology remains yet under discussion, is relevant to study many particular cases. In this work, we report a multifractal detrended fluctuation analysis (MFDFA) of electroseismic signals recorded in the Acapulco station during 1993. In October 24, 1993, occurred and earthquake (EQ) with M 6.5, with epicenter at (16.54 N, 98.98 W), 100Km away from the mentioned station. The multifractal spectrum identifies the deviations in fractal structure within time periods with large and small fluctuations. We discuss the dynamical meaning of this analysis and its possible relation with the mentioned EQ.

AIR insulin capsules of different dose strengths may be combined to yield equivalent pharmacokinetics and glucodynamics.

PubMed

de la Peña, Amparo; Seger, Mary; Rave, Klaus; Heinemann, Lutz; Silverman, Bernard; Muchmore, Douglas B

2009-09-01

In order to assess pharmacokinetic (PK) and glucodynamic (GD) attributes relevant to the end user of an inhaled insulin, this study examined the exposure and GD effect of doses of AIR inhaled insulin (Eli Lilly and Co., Indianapolis, IN) (AIR is a registered trademark of Alkermes, Inc., Cambridge, MA) by combining capsules of different strengths in healthy subjects. Fifty-nine healthy, nonsmoking, male or female subjects with normal pulmonary function were enrolled in an open-label, randomized, crossover study. Subjects underwent up to five euglycemic glucose clamp procedures, separated by 5-18 days. The five AIR insulin treatments tested included one 6 unit-equivalent (U-eq) capsule containing 2.6 mg of insulin, three 2 U-eq (0.9 mg) capsules (2.7 mg total), one 10 U-eq (3.9 mg) capsule, one 6 U-eq capsule plus two 2 U-eq capsules (4.4 mg total), and two 10 U-eq capsules (7.8 mg total). Samples for PK and GD assessments were taken up to 10 h post-dose. Based on both PK (area under the curve from time 0 to time of return to baseline and maximum concentration) and GD (total amount of glucose infused and maximum glucose infusion rate) responses, administration of a 6 U-eq capsule was equivalent to three 2 U-eq capsules; 90% confidence intervals for the ratios were contained within the interval (0.8, 1.25). Similarly, both overall exposure and glucodynamic response after administration of a 10 U-eq capsule were comparable to the 6 U-eq plus two 2 U-eq capsule combination. AIR insulin exhibited PK dose proportionality and dose-dependent increases in GD responses over the 2.6-7.8 mg dose range. AIR insulin exhibited dose strength interchangeability and dose proportionality after single-dose administration in healthy subjects.

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.

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.

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...

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.

Measurement properties of the EQ-5D-5L compared to the EQ-5D-3L in psoriasis patients.

PubMed

Poór, Adrienn Katalin; Rencz, Fanni; Brodszky, Valentin; Gulácsi, László; Beretzky, Zsuzsanna; Hidvégi, Bernadett; Holló, Péter; Kárpáti, Sarolta; Péntek, Márta

2017-12-01

The purpose of this study is to assess the measurement properties of EQ-5D-5L compared to EQ-5D-3L in psoriasis patients. A cross-sectional survey was carried out at an academic dermatology clinic in Hungary. Psoriasis patients completed the EQ-5D-3L, EQ-5D-5L and Dermatology Life Quality Index (DLQI) questionnaires, and Psoriasis Area and Severity Index (PASI) was assessed. The UK value sets were used to calculate the 3L and 5L index scores. We tested the feasibility, ceiling effect, redistribution properties, the level of inconsistency and informativity (Shannon and Shannon Evenness indices). Spearman's rank-order correlations were performed between EQ-5D, EQ VAS, DLQI and PASI scores. Known-groups validity was evaluated by comparing age groups, clinical subtypes and treatment groups. Mean age of the 238 patients was 47 years, and 36.6% of them received biological therapy. Mean EQ-5D index score was 0.77 (SD: 0.26) with the 3L and 0.84 (SD: 0.19) with the 5L. The overall ceiling effect decreased from 37.1 (3L) to 32.9% (5L). Shannon index improved significantly for most dimensions, but Shannon Evenness index improved only in three dimensions. Compared to the 3L, the 5L version confirmed a better convergent validity with PASI, but not with the DLQI. Known-groups validity was equally demonstrated both for the 5L and 3L. The EQ-5D-5L seems to improve measurement properties by reducing ceiling effects, strengthening correlations with PASI and improving informativity. Follow-up studies are needed to test responsiveness and reliability in psoriasis.

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.

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.

Recycling of paper: accounting of greenhouse gases and global warming contributions.

PubMed

Merrild, Hanna; Damgaard, Anders; Christensen, Thomas H

2009-11-01

Greenhouse gas (GHG) emissions have been established for recycling of paper waste with focus on a material recovery facility (MRF). The MRF upgrades the paper and cardboard waste before it is delivered to other industries where new paper or board products are produced. The accounting showed that the GHG contributions from the upstream activities and operational activities, with global warming factors (GWFs) of respectively 1 to 29 and 3 to 9 kg CO(2)-eq. tonne(- 1) paper waste, were small in comparison wih the downstream activities. The GHG contributions from the downstream reprocessing of the paper waste ranged from approximately 490 to 1460 kg CO(2)-eq. tonne( -1) of paper waste. The system may be expanded to include crediting of avoided virgin paper production which would result in GHG contributions from -1270 to 390 kg CO(2)-eq. tonne(- 1) paper waste. It may also be assumed that the wood not used for virgin paper production instead is used for production of energy that in turn is assumed to substitute for fossil fuel energy. This would result in GHG contributions from -1850 to -4400 kg CO(2)-eq. tonne(- 1) of paper waste. These system expansions reveal very large GHG savings, suggesting that the indirect upstream and operational GHG contributions are negligible in comparison with the indirect downstream emissions. However, the data for reprocessing of paper waste and the data for virgin paper production are highly variable. These differences are mainly related to different energy sources for the mills, both in regards to energy form (heat or electricity) and fuel (biomass or fossil fuels).

Environmental building policy by the use of microalgae and decreasing of risks for Canadian oil sand sector development.

PubMed

Avagyan, Armen B

2017-09-01

Environmental building recommendations aimed towards new environmental policies and management-changing decisions which as example demonstrated in consideration of the problems of Canadian oil sands operators. For the implementation of the circular economic strategy, we use an in-depth analysis of reported environmental after-consequence on all stages of the production process. The study addressed the promotion of innovative solutions for greenhouse gas emission, waste mitigation, and risk of falling in oil prices for operators of oil sands with creating market opportunities. They include the addition of microalgae biomass in tailings ponds for improvement of the microbial balance for the water speedily cleaning, recycling, and reusing with mitigation of GHG emissions. The use of food scraps for the nutrition of microalgae will reduce greenhouse gas emission minimally, on 0.33 MtCO 2 eq for Alberta and 2.63 MtCO 2 eq/year for Canada. Microalgae-derived biofuel can reduce this emission for Alberta on 11.9-17.9 MtCO 2 eq and for Canada on 71-106 MtCO 2 eq/year, and the manufacturing of other products will adsorb up to 135.6 MtCO 2 and produce 99.2 MtO 2 . The development of the Live Conserve Industry and principal step from non-efficient protection of the environment to its cultivation in a large scale with mitigation of GHG emission and waste as well as generating of O 2 and value-added products by the use of microalgae opens an important shift towards a new design and building of a biological system.

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.

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.

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.

Comprehensive model-based prediction of micropollutants from diffuse sources in the Swiss river network

NASA Astrophysics Data System (ADS)

Strahm, Ivo; Munz, Nicole; Braun, Christian; Gälli, René; Leu, Christian; Stamm, Christian

2014-05-01

Water quality in the Swiss river network is affected by many micropollutants from a variety of diffuse sources. This study compares, for the first time, in a comprehensive manner the diffuse sources and the substance groups that contribute the most to water contamination in Swiss streams and highlights the major regions for water pollution. For this a simple but comprehensive model was developed to estimate emission from diffuse sources for the entire Swiss river network of 65 000 km. Based on emission factors the model calculates catchment specific losses to streams for more than 15 diffuse sources (such as crop lands, grassland, vineyards, fruit orchards, roads, railways, facades, roofs, green space in urban areas, landfills, etc.) and more than 130 different substances from 5 different substance groups (pesticides, biocides, heavy metals, human drugs, animal drugs). For more than 180 000 stream sections estimates of mean annual pollutant loads and mean annual concentration levels were modeled. This data was validated with a set of monitoring data and evaluated based on annual average environmental quality standards (AA-EQS). Model validation showed that the estimated mean annual concentration levels are within the range of measured data. Therefore simulations were considered as adequately robust for identifying the major sources of diffuse pollution. The analysis depicted that in Switzerland widespread pollution of streams can be expected. Along more than 18 000 km of the river network one or more simulated substances has a concentration exceeding the AA-EQS. In single stream sections it could be more than 50 different substances. Moreover, the simulations showed that in two-thirds of small streams (Strahler order 1 and 2) at least one AA-EQS is always exceeded. The highest number of substances exceeding the AA-EQS are in areas with large fractions of arable cropping, vineyards and fruit orchards. Urban areas are also of concern even without considering wastewater treatment plants. Only a small number of problematic substances are expected from grassland. Landfills and roadways are insignificant within the entire Swiss river network, but may locally lead to considerable water pollution. Considering all substance groups, pesticides and some heavy metals are the main polluters. Many pesticides are expected to exceed AA-EQS and in a substantial percentage of the river network. Modeling a large number of substances from many sources and a huge quantity of stream sections is only possible with a simple model. Nevertheless conclusions are robust and may indicate where and for what kind of substance groups additional efforts for water quality improvements should be undertaken.

Frailty and quality of life among older people with and without a cancer diagnosis: Findings from TOPICS-MDS

PubMed Central

Schoon, Yvonne; van Goor, Harry; Olde Rikkert, Marcel; Melis, René

2017-01-01

Background The number of older cancer patients is rising. Especially in older people, treatment considerations should balance the impact of disease and treatment on quality of life (QOL) and survival. How a cancer diagnosis in older people interacts with concomitant frailty to impact on QOL is largely unknown. We aimed to determine the association between frailty and QOL among community-dwelling older people aged 65 years or above with and without a cancer diagnosis cross-sectionally and at 12 months follow-up. Methods Data were derived from the TOPICS-MDS database. Frailty was quantified by a frailty index (FI). QOL was measured with the subjective Cantril’s Self Anchoring Ladder (CSAL, range: 0–10) and the health-related EuroQol-5D (EQ-5D, range:-0.33–1.00) at baseline and after 12 months. To determine associations, linear mixed models were used. Results 7493 older people (78.6±6.4 years, 58.4% female) were included. Dealing with a cancer diagnosis (n = 751) was associated with worse QOL both at baseline (CSAL:-0.25 (95%-CI:-0.36;-0.14), EQ-5D:-0.03 (95%-CI:-0.05;-0.02)) and at follow-up (CSAL:-0.13 (95%-CI:-0.24;-0.02), EQ-5D:-0.02 (95%-CI:-0.03;-0.00)). A ten percent increase in frailty was also associated with a decrease in QOL at baseline (CSAL:-0.35 (95%-CI:-0.38;-0.32), EQ-5D:-0.12 (95%-CI:-0.12;-0.11)) and follow-up (CSAL:-0.27 (95%-CI:-0.30;-0.24), EQ-5D:-0.07 (95%-CI:-0.07;-0.06)). When mutually adjusting for frailty and a cancer diagnosis, associations between a cancer diagnosis and QOL only remained significant for CSAL at baseline (-0.14 (95%-CI:-0.25;-0.03)), whereas associations between frailty and QOL remained significant for all QOL outcomes at baseline and follow-up. No statistical interactions between cancer and frailty in their combined impact on QOL were found. Conclusions Cancer diagnosis and frailty were associated with worse health-related and self-perceived QOL both at baseline and at follow-up. Differences in QOL between older people with and without a cancer diagnosis were explained to a large extent by differences in frailty levels. This stresses the importance to take into account frailty in routine oncologic care. PMID:29244837

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.

Volterra Transfer Functions from Pulse Tests for Mildly Nonlinear Channels.

DTIC Science & Technology

1983-07-01

printing(1215) = 0 minimal printing = 1 maximum printing IFIX noise correction option = 0 no correction S1 do noise correction IPLI and IPL2 plot options...TITLE READ(5,1)N1,tI,ISKIP,IREM,IBIAS,IO)LY,DELTA, +OSAV,VAR,DFAC READ(5,1021)TITLE READ(5,I001)IPR, IFIX,IPL1, IPL2 IF(II.EQ.10000)GO To 4320...1)VIRITE (6,1004) IF(IPLT.EQ.1.OR. IPLT.EQ.3) +CALL PLOTIT(DATA2,2,11I~l,,rP,ISEIP,NIAXPL,1,1.0) IFCIPLT. EQ.1.OR. IPL2 .EQ. 0)GO TO 6544 C LABEL(18

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...

Changes in Serum Bicarbonate Levels Caused by Acetate-Containing Bicarbonate-Buffered Hemodialysis Solution: An Observational Prospective Cohort Study.

PubMed

Panesar, Mandip; Shah, Neal; Vaqar, Sarosh; Ivaturi, Kaushik; Gudleski, Gregory; Muscarella, Mary; Lambert, Judy; Su, Winnie; Murray, Brian

2017-04-01

Fresenius Medical Care's NaturaLyte dialysate has been associated with increased risk of sudden cardiac death by causing metabolic alkalosis from its acetate content based on retrospective data using pre-dialysis bicarbonate levels only. The study objective was to measure inter/intra-dialytic changes in serum bicarbonate and degree of alkalosis conferred by varying concentrations of NaturaLyte bicarbonate dialysate. Thirty-nine hemodialysis patients were divided into four groups based on prescribed bicarbonate dialysate concentrations; Group 1 (N = 9): 30-32 mEq/L, Group 2 (N = 5): 33-34 mEq/L, Group 3 (N = 10): 35-36 mEq/L, Group 4 (N = 15): 37-40 mEq/L. Serial (pre-dialysis, immediate post-dialysis, 2 h post-dialysis, and 68 h post-dialysis) bicarbonate levels were measured. Mean pre-dialysis serum bicarbonate levels (representing 44 h post-dialysis levels) in all four groups were not statistically different. Pre-dialysis and 68 h post-dialysis bicarbonate levels in each group were also not significantly different. However, immediate post-dialysis and 2 h post-dialysis bicarbonate levels were significantly increased in all four groups proportional to dialysate dose. There was statistically significant inter-group bicarbonate level difference (P < 0.05) except between the first and second (P = 0.43) and second and third (P = 0.07) groups in the immediate post-dialysis period. Similar results were obtained for the 2 h post-dialysis period. High bicarbonate dialysate causes large and rapid fluctuations in serum bicarbonate levels during the intra/inter-dialytic period, which returns to baseline within 44 to 68 h after dialysis. This refutes the necessity to correct pre-dialysis acidosis with high bicarbonate dialysate since rapid equilibration is likely to occur and unnecessarily exposes patients to large shifts in their acid base balance. © 2017 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy.

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

Parameters of loop-controlled magnetic rheology drive for segmented large mirror

NASA Astrophysics Data System (ADS)

Deulin, Eugeni A.; Mikhailov, Valeri P.; Eliseev, Oleg N.; Sytchev, Victor V.

2000-07-01

The design, parameters and the amplitude-frequency analysis of the new magnetic rheology (MR) drive are presented. The combination of hydrostatic carrier, MR hydraulic loop control, elastic thin wall seal joined in a single unit ensures small positioning error nm and small time of response T

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.

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

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.

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.

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

Lifecycle assessment of microalgae to biofuel: Comparison of thermochemical processing pathways

DOE PAGES

Bennion, Edward P.; Ginosar, Daniel M.; Moses, John; ...

2015-01-16

Microalgae are currently being investigated as a renewable transportation fuel feedstock based on various advantages that include high annual yields, utilization of poor quality land, does not compete with food, and can be integrated with various waste streams. This study focuses on directly assessing the impact of two different thermochemical conversion technologies on the microalgae to biofuel process through life cycle assessment. A system boundary of a “well to pump” (WTP) is defined and includes sub-process models of the growth, dewatering, thermochemical bio-oil recovery, bio-oil stabilization, conversion to renewable diesel, and transport to the pump. Models were validated with experimentalmore » and literature data and are representative of an industrial-scale microalgae to biofuel process. Two different thermochemical bio-oil conversion systems are modeled and compared on a systems level, hydrothermal liquefaction (HTL) and pyrolysis. The environmental impact of the two pathways were quantified on the metrics of net energy ratio (NER), defined here as energy consumed over energy produced, and greenhouse gas (GHG) emissions. Results for WTP biofuel production through the HTL pathway were determined to be 1.23 for the NER and GHG emissions of -11.4 g CO 2-eq (MJ renewable diesel) -1. WTP biofuel production through the pyrolysis pathway results in a NER of 2.27 and GHG emissions of 210 g CO2 eq (MJ renewable diesel)-1. The large environmental impact associated with the pyrolysis pathway is attributed to feedstock drying requirements and combustion of co-products to improve system energetics. Discussion focuses on a detailed breakdown of the overall process energetics and GHGs, impact of modeling at laboratory- scale compared to industrial-scale, environmental impact sensitivity to engineering systems input parameters for future focused research and development and a comparison of results to literature.« less

Life cycle assessment of microalgae to biofuel: Thermochemical processing through hydrothermal liquefaction or pyrolysis

NASA Astrophysics Data System (ADS)

Bennion, Edward P.

Microalgae are currently being investigated as a renewable transportation fuel feedstock based on various advantages that include high annual yields, utilization of poor quality land, does not compete with food, and can be integrated with various waste streams. This study focuses on directly assessing the impact of two different thermochemical conversion technologies on the microalgae-to-biofuel process through life cycle assessment. A system boundary of a "well to pump" (WTP) is defined and includes sub-process models of the growth, dewatering, thermochemical bio-oil recovery, bio-oil stabilization, conversion to renewable diesel, and transport to the pump. Models were validated with experimental and literature data and are representative of an industrial-scale microalgae-to-biofuel process. Two different thermochemical bio-oil conversion systems are modeled and compared on a systems level, hydrothermal liquefaction (HTL) and pyrolysis. The environmental impact of the two pathways were quantified on the metrics of net energy ratio (NER), defined here as energy consumed over energy produced, and greenhouse gas (GHG) emissions. Results for WTP biofuel production through the HTL pathway were determined to be 1.23 for the NER and GHG emissions of -11.4 g CO2 eq (MJ renewable diesel)-1. WTP biofuel production through the pyrolysis pathway results in a NER of 2.27 and GHG emissions of 210 g CO2 eq (MJ renewable diesel)-1. The large environmental impact associated with the pyrolysis pathway is attributed to feedstock drying requirements and combustion of co-products to improve system energetics. Discussion focuses on a detailed breakdown of the overall process energetics and GHGs, impact of modeling at laboratory-scale compared to industrial-scale, environmental impact sensitivity to engineering systems input parameters for future focused research and development, and a comparison of results to literature.

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.

Life cycle energy use, costs, and greenhouse gas emission of broiler farms in different production systems in Iran-a case study of Alborz province.

PubMed

Pishgar-Komleh, Seyyed Hassan; Akram, Asadollah; Keyhani, Alireza; van Zelm, Rosalie

2017-07-01

In order to achieve sustainable development in agriculture, it is necessary to quantify and compare the energy, economic, and environmental aspects of products. This paper studied the energy, economic, and greenhouse gas (GHG) emission patterns in broiler chicken farms in the Alborz province of Iran. We studied the effect of the broiler farm size as different production systems on the energy, economic, and environmental indices. Energy use efficiency (EUE) and benefit-cost ratio (BCR) were 0.16 and 1.11, respectively. Diesel fuel and feed contributed the most in total energy inputs, while feed and chicks were the most important inputs in economic analysis. GHG emission calculations showed that production of 1000 birds produces 19.13 t CO 2-eq and feed had the highest share in total GHG emission. Total GHG emissions based on different functional units were 8.5 t CO 2-eq per t of carcass and 6.83 kg CO 2-eq per kg live weight. Results of farm size effect on EUE revealed that large farms had better energy management. For BCR, there was no significant difference between farms. Lower total GHG emissions were reported for large farms, caused by better management of inputs and fewer bird losses. Large farms with more investment had more efficient equipment, resulting in a decrease of the input consumption. In view of our study, it is recommended to support the small-scale broiler industry by providing subsidies to promote the use of high-efficiency equipment. To decrease the amount of energy usage and GHG emissions, replacing heaters (which use diesel fuel) with natural gas heaters can be considered. In addition to the above recommendations, the use of energy saving light bulbs may reduce broiler farm electricity consumption.

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

Adam, W.; Bergauer, T.; Brondolin, E.

The high luminosity upgrade of the Large Hadron Collider, foreseen for 2026, necessitates the replacement of the CMS experiment’s silicon tracker. The innermost layer of the new pixel detector will be exposed to severe radiation, corresponding to a 1 MeV neutron equivalent fluence of up tomore » $$\\Phi _{eq} = 2 \\times 10^{16}$$  cm$$^{-2}$$ , and an ionising dose of $${\\approx } 5$$  MGy after an integrated luminosity of 3000 fb$$^{-1}$$ . Thin, planar silicon sensors are good candidates for this application, since the degradation of the signal produced by traversing particles is less severe than for thicker devices. Here in this article, the results obtained from the characterisation of 100 and 200 μm thick p-bulk pad diodes and strip sensors irradiated up to fluences of $$\\Phi _{eq} = 1.3 \\times 10^{16}$$  cm$$^{-2}$$ are shown.« less

Mapping specificity landscapes of RNA-protein interactions by high throughput sequencing.

PubMed

Jankowsky, Eckhard; Harris, Michael E

2017-04-15

To function in a biological setting, RNA binding proteins (RBPs) have to discriminate between alternative binding sites in RNAs. This discrimination can occur in the ground state of an RNA-protein binding reaction, in its transition state, or in both. The extent by which RBPs discriminate at these reaction states defines RBP specificity landscapes. Here, we describe the HiTS-Kin and HiTS-EQ techniques, which combine kinetic and equilibrium binding experiments with high throughput sequencing to quantitatively assess substrate discrimination for large numbers of substrate variants at ground and transition states of RNA-protein binding reactions. We discuss experimental design, practical considerations and data analysis and outline how a combination of HiTS-Kin and HiTS-EQ allows the mapping of RBP specificity landscapes. Copyright © 2017 Elsevier Inc. All rights reserved.

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.

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.

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.

The Predictive Value of Preoperative Health-Related Quality-of-Life Scores on Postoperative Patient-Reported Outcome Scores in Lumbar Spine Surgery

PubMed Central

Hey, Hwee Weng Dennis; Luo, Nan; Chin, Sze Yung; Lau, Eugene Tze Chun; Wang, Pei; Kumar, Naresh; Lau, Leok-Lim; Ruiz, John Nathaniel; Thambiah, Joseph Shanthakumar; Liu, Ka-Po Gabriel; Wong, Hee-Kit

2017-01-01

Study Design: A single-center, retrospective cohort study. Objective: To predict patient-reported outcomes (PROs) using preoperative health-related quality-of-life (HRQoL) scores by quantifying the correlation between them, so as to aid selection of surgical candidates and preoperative counselling. Methods: All patients who underwent single-level elective lumbar spine surgery over a 2-year period were divided into 3 diagnosis groups: spondylolisthesis, spinal stenosis, and disc herniation. Patient characteristics and health scores (Oswestry Low Back Pain and Disability Index [ODI], EQ-5D, and Short Form-36 version 2 [SF-36v2]) were collected at 6 and 24 months and compared between the 3 diagnosis groups. Multivariate modelling was performed to investigate the predictive value of each parameter, particularly preoperative ODI and EQ-5D, on postoperative ODI and EQ-5D scores for all the patients. Results: ODI and EQ-5D at 6 and 24 months improved significantly for all patients, especially in the disc herniation group, compared to the baseline. The magnitude of improvement in ODI and EQ-5D was predictable using preoperative ODI, EQ-5D, and SF-36v2 Mental Component Score. At 6 months, 1-point baseline ODI predicts for 0.7-point increase in changed ODI, and a 0.01-point increase in baseline EQ-5D predicts for 0.01-point decrease in changed EQ-5D score. At 24 months, 1-point baseline ODI predicts for 1-point increase in changed ODI, and a 0.01-point increase in baseline EQ-5D predicts for 0.009-point decrease in changed EQ-5D. A younger age is shown to be a positive predictor of ODI at 24 months. Conclusions: Poorer baseline health scores predict greater improvement in postoperative PROs at 6 and 24 months after the surgery. HRQoL scores can be used to decide on surgery and in preoperative counselling. PMID:29662746

The Predictive Value of Preoperative Health-Related Quality-of-Life Scores on Postoperative Patient-Reported Outcome Scores in Lumbar Spine Surgery.

PubMed

Hey, Hwee Weng Dennis; Luo, Nan; Chin, Sze Yung; Lau, Eugene Tze Chun; Wang, Pei; Kumar, Naresh; Lau, Leok-Lim; Ruiz, John Nathaniel; Thambiah, Joseph Shanthakumar; Liu, Ka-Po Gabriel; Wong, Hee-Kit

2018-04-01

A single-center, retrospective cohort study. To predict patient-reported outcomes (PROs) using preoperative health-related quality-of-life (HRQoL) scores by quantifying the correlation between them, so as to aid selection of surgical candidates and preoperative counselling. All patients who underwent single-level elective lumbar spine surgery over a 2-year period were divided into 3 diagnosis groups: spondylolisthesis, spinal stenosis, and disc herniation. Patient characteristics and health scores (Oswestry Low Back Pain and Disability Index [ODI], EQ-5D, and Short Form-36 version 2 [SF-36v2]) were collected at 6 and 24 months and compared between the 3 diagnosis groups. Multivariate modelling was performed to investigate the predictive value of each parameter, particularly preoperative ODI and EQ-5D, on postoperative ODI and EQ-5D scores for all the patients. ODI and EQ-5D at 6 and 24 months improved significantly for all patients, especially in the disc herniation group, compared to the baseline. The magnitude of improvement in ODI and EQ-5D was predictable using preoperative ODI, EQ-5D, and SF-36v2 Mental Component Score. At 6 months, 1-point baseline ODI predicts for 0.7-point increase in changed ODI, and a 0.01-point increase in baseline EQ-5D predicts for 0.01-point decrease in changed EQ-5D score. At 24 months, 1-point baseline ODI predicts for 1-point increase in changed ODI, and a 0.01-point increase in baseline EQ-5D predicts for 0.009-point decrease in changed EQ-5D. A younger age is shown to be a positive predictor of ODI at 24 months. Poorer baseline health scores predict greater improvement in postoperative PROs at 6 and 24 months after the surgery. HRQoL scores can be used to decide on surgery and in preoperative counselling.

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.

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

Past, present and future concentrations of ground-level ozone and potential impacts on ecosystems and human health in northern Europe.

PubMed

Karlsson, Per Erik; Klingberg, Jenny; Engardt, Magnuz; Andersson, Camilla; Langner, Joakim; Karlsson, Gunilla Pihl; Pleijel, Håkan

2017-01-15

This review summarizes new information on the current status of ground-level ozone in Europe north of the Alps. There has been a re-distribution in the hourly ozone concentrations in northern Europe during 1990-2015. The highest concentrations during summer daytime hours have decreased while the summer night-time and winter day- and night-time concentrations have increased. The yearly maximum 8-h mean concentrations ([O 3 ] 8h,max ), a metric used to assess ozone impacts on human health, have decreased significantly during 1990-2015 at four out of eight studied sites in Fennoscandia and northern UK. Also the annual number of days when the yearly [O 3 ] 8h,max exceeded the EU Environmental Quality Standard (EQS) target value of 60ppb has decreased. In contrast, the number of days per year when the yearly [O 3 ] 8h,max exceeded 35ppb has increased significantly at two sites, while it decreased at one far northern site. [O 3 ] 8h,max is predicted not to exceed 60ppb in northern UK and Fennoscandia after 2020. However, the WHO EQS target value of 50ppb will still be exceeded. The AOT40 May-July and AOT40 April-September metrics, used for the protection of vegetation, have decreased significantly at three and four sites, respectively. The EQS for the protection of forests, AOT40 April-September 5000ppbh, is projected to no longer be exceeded for most of northern Europe sometime before the time period 2040-2059. However, if the EQS is based on Phytotoxic Ozone Dose (POD), POD 1 , it may still be exceeded by 2050. The increasing trend for low and medium range ozone concentrations in combination with a decrease in high concentrations indicate that a new control strategy, with a larger geographical scale than Europe and including methane, is needed for ozone abatement in northern Europe. Copyright © 2016 Elsevier B.V. All rights reserved.

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.

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

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.

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.

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).

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

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 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.

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.

Bioavailability of potassium from potatoes and potassium gluconate: a randomized dose response trial.

PubMed

Macdonald-Clarke, Claire J; Martin, Berdine R; McCabe, Linda D; McCabe, George P; Lachcik, Pamela J; Wastney, Meryl; Weaver, Connie M

2016-08-01

The bioavailability of potassium should be considered in setting requirements, but to our knowledge, the bioavailability from individual foods has not been determined. Potatoes provide 19-20% of potassium in the American diet. We compared the bioavailability and dose response of potassium from nonfried white potatoes with skin [targeted at 20, 40, and 60 milliequivalents (mEq) K] and French fries (40 mEq K) with potassium gluconate at the same doses when added to a basal diet that contained ∼60 mEq K. Thirty-five healthy, normotensive men and women with a mean ± SD age of 29.7 ± 11.2 y and body mass index (in kg/m(2)) of 24.3 ± 4.4 were enrolled in a single-blind, crossover, randomized controlled trial. Participants were partially randomly assigned to the order of testing for nine 5-d interventions of additional potassium as follows: 0 (control; repeated at phases 1 and 5), 20, 40, and 60 mEq K/d consumed as a potassium gluconate supplement or as unfried potato or 40 mEq K from French fries completed at phase 9. The bioavailability of potassium was determined from the area under the curve (AUC) of serial blood draws and cumulative urinary excretion during a 24-h period and from a kinetic analysis. The effects of the potassium source and dose on the change in blood pressure and augmentation index (AIx) were determined. The serum potassium AUC increased with the dose (P < 0.0001) and did not differ because of the source (P = 0.53). Cumulative 24-h urinary potassium also increased with the dose (P < 0.0001) and was greater with the potato than with the supplement (P < 0.0001). The kinetic analysis showed the absorption efficiency was high across all interventions (>94% ± 12%). There were no significant differences in the change in blood pressure or AIx with the treatment source or dose. The bioavailability of potassium is as high from potatoes as from potassium gluconate supplements. Future studies that measure the effect of dietary potassium on blood pressure will need to evaluate the effect of various dietary sources on potassium retention and in both normal and hypertensive populations. This trial was registered at clinicaltrials.gov as NCT01881295. © 2016 American Society for Nutrition.

The Effects of Hydrogen Band EMIC Waves on Ring Current H+ Ions

NASA Astrophysics Data System (ADS)

Wang, Zhiqiang; Zhai, Hao; Gao, Zhuxiu

2017-12-01

Hydrogen band electromagnetic ion cyclotron (EMIC) waves have received much attention recently because they are found to frequently span larger spatial areas than the other band EMIC waves. Using test particle simulations, we study the nonlinear effects of hydrogen band EMIC waves on ring current H+ ions. A dimensionless parameter R is used to characterize the competition between wave-induced and adiabatic motions. The results indicate that there are three regimes of wave-particle interactions for typical 35 keV H+ ions at L = 5: diffusive (quasi-linear) behavior when αeq ≤ 35° (R ≥ 2.45), the nonlinear phase trapping when 35° < αeq < 50° (0.75 < R < 2.45), and both the nonlinear phase bunching and phase trapping when αeq ≥ 50° (R ≤ 0.75). The phase trapping can transport H+ ions toward large pitch angle, while the phase bunching has the opposite effect. The phase-trapped H+ ions can be significantly accelerated (from 35 keV to over 500 keV) in about 4 min and thus contribute to the formation of high energy components of ring current ions. The results suggest that the effect of hydrogen band EMIC waves is not ignorable in the nonlinear acceleration and resonance scattering of ring current H+ ions.

Energy use and recovery in waste management and implications for accounting of greenhouse gases and global warming contributions.

PubMed

Fruergaard, Thilde; Astrup, Tomas; Ekvall, Thomas

2009-11-01

The energy system plays an essential role in accounting of greenhouse gas (GHG) emissions from waste management systems and waste technologies. This paper focuses on energy use and energy recovery in waste management and outlines how these aspects should be addressed consistently in a GHG perspective. Essential GHG emission data for the most common fuels, electricity and heat are provided. Average data on electricity provision show large variations from country to country due to different fuels being used and different efficiencies for electricity production in the individual countries (0.007-1.13 kg CO(2)-eq. kWh(-1)). Marginal data on electricity provision show even larger variations (0.004-3 kg CO(2)-eq. kWh( -1)). Somewhat less variation in GHG emissions is being found for heat production (0.01-0.69 kg CO(2)-eq. kWh( -1)). The paper further addresses allocation principles and the importance of applying either average or marginal energy data, and it discusses the consequences of introducing reduction targets on CO( 2) emissions. All discussed aspects were found to significantly affect the outcome of GHG accounts suggesting transparent reporting to be critical. Recommendations for use of average/marginal energy data are provided.

Sensitivity of high-elevation streams in the Southern Blue Ridge Province to acidic deposition

USGS Publications Warehouse

Winger, P.V.; Lasier, P.J.; Hudy, M.; Fowler, D.; Van Den Avyle, M.J.

1987-01-01

The Southern Blue Ridge Province, which encompasses parts of northern Georgia, eastern Tennessee, and western North Carolina, has been predicted to be sensitive to impacts from acidic deposition, owing to the chemical composition of the bedrock geology and soils. This study confirms the predicted potential sensitivity, quantifies the level of total alkalinity and describes the chemical characteristics of 30 headwater streams of this area. Water chemistry was measured five times between April 1983 and June 1984 at first and third order reaches of each stream during baseflow conditions. Sensitivity based on total alkalinity and the Calcite Saturation Index indicates that the headwater streams of the Province are vulnerable to acidification. Total alkalinity and p11 were generally higher in third order reaches (mean, 72 ?eq/? and 6.7) than in first order reaches (64 ?eq/? and 6.4). Ionic concentrations were low, averaging 310 and 340 ?eq/? in first and third order reaches, respectively. A single sampling appears adequate for evaluating sensitivity based on total alkalinity, but large temporal variability requires multiple sampling for the detection of changes in pH and alkalinity over time. Monitoring of stream water should continue in order to detect any subtle effects of acidic deposition on these unique resource systems.

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.

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.

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.

Methane and CO2 emissions from China's hydroelectric reservoirs: a new quantitative synthesis.

PubMed

Li, Siyue; Zhang, Quanfa; Bush, Richard T; Sullivan, Leigh A

2015-04-01

Controversy surrounds the green credentials of hydroelectricity because of the potentially large emission of greenhouse gases (GHG) from associated reservoirs. However, limited and patchy data particularly for China is constraining the current global assessment of GHG releases from hydroelectric reservoirs. This study provides the first evaluation of the CO2 and CH4 emissions from China's hydroelectric reservoirs by considering the reservoir water surface and drawdown areas, and downstream sources (including spillways and turbines, as well as river downstream). The total emission of 29.6 Tg CO2/year and 0.47 Tg CH4/year from hydroelectric reservoirs in China, expressed as CO2 equivalents (eq), corresponds to 45.6 Tg CO2eq/year, which is 2-fold higher than the current GHG emission (ca. 23 Tg CO2eq/year) from global temperate hydropower reservoirs. China's average emission of 70 g CO2eq/kWh from hydropower amounts to 7% of the emissions from coal-fired plant alternatives. China's hydroelectric reservoirs thus currently mitigate GHG emission when compared to the main alternative source of electricity with potentially far great reductions in GHG emissions and benefits possible through relatively minor changes to reservoir management and design. On average, the sum of drawdown and downstream emission including river reaches below dams and turbines, which is overlooked by most studies, represents the equivalent of 42% of the CO2 and 92% of CH4 that emit from hydroelectric reservoirs in China. Main drivers on GHG emission rates are summarized and highlight that water depth and stratification control CH4 flux, and CO2 flux shows significant negative relationships with pH, DO, and Chl-a. Based on our finding, a substantial revision of the global carbon emissions from hydroelectric reservoirs is warranted.

Renner-Teller quantum dynamics of NH(a(1)Delta) + H reactions on the NH(2) A(2)A(1) and X(2)B(1) coupled surfaces.

PubMed

Defazio, P; Gamallo, P; González, M; Petrongolo, C

2010-09-16

Four reactions NH(a1Delta) + H′(2S) are investigated by the quantum mechanical real wavepacket method, taking into account nonadiabatic Renner-Teller (RT) and rovibronic Coriolis couplings between the involved states. We consider depletion (d) to N(2D) + H2(X1Sigmag+), exchange (e) to NH′(a1Delta) + H(2S), quenching (q) to NH(X3Sigma-) + H′(2S), and exchange-quenching (eq) to NH′(X3Sigma-) + H(2S). We extend our RT theory to a general AB + C collision using a geometry-dependent but very simple and empirical RT matrix element. Reaction probabilities, cross sections, and rate constants are presented, and RT results are compared with Born-Oppenheimer (BO), experimental, and semiclassical data. The nonadiabatic couplings open two new channels, (q) and (eq), and increase the (d) and (e) reactivity with respect to the BO one, when NH(a1Delta) is rotationally excited. In this case, the quantum cross sections are larger than the semiclassical ones at low collision energies. The calculated rate constants at 300 K are k(d) = 3.06, k(e) = 3.32, k(q) = 1.44, and k(eq) = 1.70 in 10(-11) cm3 s(-1) compared with the measured values k(d) = (3.2 =/- 1.7), k(q + eq) = (1.7 +/- 0.3), and k(total) = (4.8 +/- 1.7). The theoretical depletion rate is thus in good agreement with the experimental value, but the quenching and total rates are overestimated, because the present RT couplings are too large. This discrepancy is probably due to our simple and empirical RT matrix element.

Sodium polystyrene sulfonate for the treatment of acute hyperkalemia: a retrospective study.

PubMed

Hagan, Amanda E; Farrington, Crystal A; Wall, Geoffrey C; Belz, Mark M

2016-01-01

Hyperkalemia is a common problem in hospitalized patients, especially those with underlying chronic kidney disease, but evidence-based guidelines for its treatment are lacking. Sodium polystyrene sulfonate (SPS), a cation exchange resin first approved by the FDA for the treatment of hyperkalemia in 1958, is frequently used alone or in conjunction with other medical therapies to lower serum potassium. Recently, the safety and efficacy of SPS have come into question based on multiple reported cases of bowel necrosis associated with SPS administration. The primary objective of this study was to evaluate the use of SPS for the treatment of hyperkalemia, at a large tertiary community teaching hospital, to determine its effectiveness and the incidence of related adverse side effects. A retrospective chart review was performed on all adult inpatients receiving single-dose SPS at a 466-bed tertiary community teaching hospital over a 3-year period. 501 patients received SPS for the treatment of hyperkalemia during their index hospital stay. Serum potassium levels decreased by 0.93 mEq/L on average at first recheck after SPS administration, with or without additional medical treatments. Our study identified 10 cases of hypernatremia (greater than 145 mEq/L), 31 cases of hypokalemia (less than 3.5 mEq/L), and 2 cases of bowel necrosis related to the administration of SPS. Our results suggest a serum potassium reduction of less than 1 mEq/L after administration of SPS for the treatment of acute hyperkalemia. Additionally, this study offers some evidence that the use of SPS may be associated with harm. We further note the need for standardized guidelines for the treatment of hyperkalemia at our institution.

Greenhouse gas contribution of municipal solid waste collection: A case study in the city of Istanbul, Turkey.

PubMed

Korkut, Nafiz E; Yaman, Cevat; Küçükağa, Yusuf; Jaunich, Megan K; Demir, İbrahim

2018-02-01

This article estimates greenhouse gas emissions and global warming factors resulting from collection of municipal solid waste to the transfer stations or landfills in Istanbul for the year of 2015. The aim of this study is to quantify and compare diesel fuel consumption and estimate the greenhouse gas emissions and global warming factors associated with municipal solid waste collection of the 39 districts of Istanbul. Each district's greenhouse gas emissions resulting from the provision and combustion of diesel fuel was estimated by considering the number of collection trips and distances to municipal solid waste facilities. The estimated greenhouse gases and global warming factors for the districts varied from 61.2 to 2759.1 t CO 2 -eq and from 4.60 to 15.20 kg CO 2 -eq t -1 , respectively. The total greenhouse gas emission was estimated as 46.4E3 t CO 2 -eq. Lastly, the collection data from the districts was used to parameterise a collection model that can be used to estimate fuel consumption associated with municipal solid waste collection. This mechanistic model can then be used to predict future fuel consumption and greenhouse gas emissions associated with municipal solid waste collection based on projected population, waste generation, and distance to transfer stations and landfills. The greenhouse gas emissions can be reduced by decreasing the trip numbers and trip distances, building more transfer stations around the city, and making sure that the collection trucks are full in each trip.

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.

Hemodialysis clearance of glyphosate following a life-threatening ingestion of glyphosate-surfactant herbicide.

PubMed

Garlich, F M; Goldman, M; Pepe, J; Nelson, L S; Allan, M J; Goldstein, D A; Goldfarb, D S; Hoffman, R S

2014-01-01

Ingestion of glyphosate-surfactant herbicides (GlySH) can result in acute kidney injury, electrolyte abnormalities, acidosis, cardiovascular collapse, and death. In severe toxicity, the use of hemodialysis is reported, but largely unsupported by kinetic analysis. We report the dialysis clearance of glyphosate following a suicidal ingestion of a glyphosate-containing herbicide. A 62-year-old man was brought to the emergency department (ED) 8.5 h after drinking a bottle of commercial herbicide containing a 41% solution of glyphosate isopropylamine, in polyoxyethyleneamine (POEA) surfactant and water. He was bradycardic and obtunded with respiratory depression necessitating intubation and mechanical ventilation. Initial laboratory results were significant for the following: pH, 7.11; PCO2, 64 mmHg; PO2, 48 mmHg; potassium, 7.8 mEq/L; Cr 3.3, mg/dL; bicarbonate, 22 mEq/L; anion gap, 18 mEq/L; and lactate, 7.5 mmol/L. Acidosis and hyperkalemia persisted despite ventilation and fluid resuscitation. The patient underwent hemodialysis 16 h post ingestion, after which he demonstrated resolution of acidosis and hyperkalemia, and improvement in clinical status. Serum glyphosate concentrations were drawn prior to, during, and after hemodialysis. The extraction ratio and hemodialysis clearance were calculated to be 91.8% and 97.5 mL/min, respectively. We demonstrate the successful clearance of glyphosate using hemodialysis, with corresponding clinical improvement in a patient with several poor prognostic factors (advanced age, large volume ingested, and impaired consciousness). The effects of hemodialysis on the surfactant compound are unknown. Hemodialysis can be considered when severe acidosis and acute kidney injury complicate ingestion of glyphosate-containing products.

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

Integration of ecosystem services into the carbon footprint of milk of South German dairy farms.

PubMed

Robert Kiefer, Lukas; Menzel, Friederike; Bahrs, Enno

2015-04-01

Allocation of greenhouse gas emissions (GHG) in Life Cycle Assessments (LCA) is challenging especially when multi-functionality of dairy farms, which do not only produce milk but also meat is considered. Moreover, some farms fulfill a wide range of additional services for society such as management of renewable natural resources as well as preservation of biodiversity and cultural landscapes. Due to the increasing degradation of ecosystems many industrialized as well as developing countries designed payment systems for environmental services. This study examines different allocation methods of GHG for a comparatively large convenience sample of 113 dairy farms located in grassland-based areas of southern Germany. Results are carbon footprints of 1.99 kg CO2eq/kg of fat and protein corrected milk (FPCM) on average if "no allocation" for coupled products is performed. "Physical allocation" results in 1.53 kg CO2eq/kg FPCM and "conventional economic allocation" in 1.66 kg CO2eq/kg FPCM on average if emissions are apportioned between milk and meat. Economic allocation which includes ecosystem services for society based on the farm net income as a new aspect in this study results in a carbon footprint of 1.5 kg CO2eq/kg FPCM on average. System expansion that puts greater emphasis on coupled beef production accounts for a carbon footprint of 0.68 kg CO2eq/kg FPCM on average. Intense milk production systems with higher milk yields show better results based on "no allocation", "physical allocation" and "conventional economic allocation". By contrast, economic allocation, which takes into account ecosystem services favors extensive systems, especially in less favored areas. This shows that carbon footprints of dairy farms should not be examined one-dimensionally based on the amount of milk and meat that is produced on the farm. Rather, a broader perspective is necessary that takes into account the multi-functionality of dairy farms especially in countries where a wide range of ecosystem services is provided. Copyright © 2015 Elsevier Ltd. All rights reserved.

Mapping health assessment questionnaire disability index (HAQ-DI) score, pain visual analog scale (VAS), and disease activity score in 28 joints (DAS28) onto the EuroQol-5D (EQ-5D) utility score with the KORean Observational study Network for Arthritis (KORONA) registry data.

PubMed

Kim, Hye-Lin; Kim, Dam; Jang, Eun Jin; Lee, Min-Young; Song, Hyun Jin; Park, Sun-Young; Cho, Soo-Kyung; Sung, Yoon-Kyoung; Choi, Chan-Bum; Won, Soyoung; Bang, So-Young; Cha, Hoon-Suk; Choe, Jung-Yoon; Chung, Won Tae; Hong, Seung-Jae; Jun, Jae-Bum; Kim, Jinseok; Kim, Seong-Kyu; Kim, Tae-Hwan; Kim, Tae-Jong; Koh, Eunmi; Lee, Hwajeong; Lee, Hye-Soon; Lee, Jisoo; Lee, Shin-Seok; Lee, Sung Won; Park, Sung-Hoon; Shim, Seung-Cheol; Yoo, Dae-Hyun; Yoon, Bo Young; Bae, Sang-Cheol; Lee, Eui-Kyung

2016-04-01

The aim of this study was to estimate the mapping model for EuroQol-5D (EQ-5D) utility values using the health assessment questionnaire disability index (HAQ-DI), pain visual analog scale (VAS), and disease activity score in 28 joints (DAS28) in a large, nationwide cohort of rheumatoid arthritis (RA) patients in Korea. The KORean Observational study Network for Arthritis (KORONA) registry data on 3557 patients with RA were used. Data were randomly divided into a modeling set (80 % of the data) and a validation set (20 % of the data). The ordinary least squares (OLS), Tobit, and two-part model methods were employed to construct a model to map to the EQ-5D index. Using a combination of HAQ-DI, pain VAS, and DAS28, four model versions were examined. To evaluate the predictive accuracy of the models, the root-mean-square error (RMSE) and mean absolute error (MAE) were calculated using the validation dataset. A model that included HAQ-DI, pain VAS, and DAS28 produced the highest adjusted R (2) as well as the lowest Akaike information criterion, RMSE, and MAE, regardless of the statistical methods used in modeling set. The mapping equation of the OLS method is given as EQ-5D = 0.95-0.21 × HAQ-DI-0.24 × pain VAS/100-0.01 × DAS28 (adjusted R (2) = 57.6 %, RMSE = 0.1654 and MAE = 0.1222). Also in the validation set, the RMSE and MAE were shown to be the smallest. The model with HAQ-DI, pain VAS, and DAS28 showed the best performance, and this mapping model enabled the estimation of an EQ-5D value for RA patients in whom utility values have not been measured.

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...

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.

Erratum: Nonlinear Dirac equation solitary waves in external fields [Phys. Rev. E 86, 046602 (2012)

DOE PAGES

Mertens, Franz G.; Quintero, Niurka R.; Cooper, Fred; ...

2016-05-10

In Sec. IV of our original paper, we assumed a particular conservation law Eq. (4.6), which was true in the absence of external potentials, to derive some particular potentials for which we obtained solutions to the nonlinear Dirac equation (NLDE). Because the conservation law of Eq. (4.6) for the component T 11 of the energy-momentum tensor is not true in the presence of these external potentials, the solutions we found do not satisfy the NLDEs in the presence of these potentials. Thus all the equations from Eq. (4.6) through Eq. (4.44) are not correct, since the exact solutions that followedmore » in that section presumed Eq. (4.6) was true. Also Eqs. (A3)–(A5) are a restatement of Eq. (4.6) and also are not correct. These latter equations are also not used in Sec. V and beyond. The rest of our original paper (starting with Sec. V) was not concerned with exact solutions, rather it was concerned with how the exact solitary-wave solutions to the NLDE in the absence of an external potential responded to being in the presence of various external potentials. This Erratum corrects this mistake.« less

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.

The Response of Stream and Soil Chemistry to Decreases in Acid Deposition in the Catskill Mountains, New York, USA

NASA Astrophysics Data System (ADS)

McHale, M. R.; Burns, D. A.; Siemion, J.; Antidormi, M. R.

2016-12-01

The Catskill Mountains have been adversely impacted by decades of acid deposition, however, since the early 1990s, acid deposition levels have decreased sharply as a result of decreases in emissions of sulfur dioxide and nitrogen oxides. The purpose of this study is to provide updated trends in acid deposition and stream-water chemistry in the southeastern Catskill Mountains and to examine whether soil chemistry has shown signs of recovery during the past 2 decades. We measured significant reductions in acid deposition in the region during the 23 year period from 1992 to 2014. The reductions were reflected in significant improvement in stream-water quality in all 5 of the streams included in this study. The largest and most significant trends were for sulfate (SO42-) concentrations (mean trend of -2.5 μeq L-1 yr-1 for 5 sites); hydrogen ion (H+) also decreased significantly as did inorganic monomeric aluminum (Alim) which is toxic to some aquatic biota (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 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 in part 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- deposition. This incongruity is likely caused by the large biological demand and complex cycling processes of nitrogen. Despite the decreases in stream-water acidity, we measured no recovery in soil chemistry which we attributed to soils with low buffering capacity that have 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 decreasing rate of mineral dissolution. A decreasing weathering rate would help to explain the slow recovery of stream pH and ANC as well as that of soil base cations, which has implications for assessments of critical loads in this region.

Viscoelastic Earthquake Cycle Simulation with Memory Variable Method

NASA Astrophysics Data System (ADS)

Hirahara, K.; Ohtani, M.

2017-12-01

There have so far been no EQ (earthquake) cycle simulations, based on RSF (rate and state friction) laws, in viscoelastic media, except for Kato (2002), who simulated cycles on a 2-D vertical strike-slip fault, and showed nearly the same cycles as those in elastic cases. The viscoelasticity could, however, give more effects on large dip-slip EQ cycles. In a boundary element approach, stress is calculated using a hereditary integral of stress relaxation function and slip deficit rate, where we need the past slip rates, leading to huge computational costs. This is a cause for almost no simulations in viscoelastic media. We have investigated the memory variable method utilized in numerical computation of wave propagation in dissipative media (e.g., Moczo and Kristek, 2005). In this method, introducing memory variables satisfying 1st order differential equations, we need no hereditary integrals in stress calculation and the computational costs are the same order of those in elastic cases. Further, Hirahara et al. (2012) developed the iterative memory variable method, referring to Taylor et al. (1970), in EQ cycle simulations in linear viscoelastic media. In this presentation, first, we introduce our method in EQ cycle simulations and show the effect of the linear viscoelasticity on stick-slip cycles in a 1-DOF block-SLS (standard linear solid) model, where the elastic spring of the traditional block-spring model is replaced by SLS element and we pull, in a constant rate, the block obeying RSF law. In this model, the memory variable stands for the displacement of the dash-pot in SLS element. The use of smaller viscosity reduces the recurrence time to a minimum value. The smaller viscosity means the smaller relaxation time, which makes the stress recovery quicker, leading to the smaller recurrence time. Second, we show EQ cycles on a 2-D dip-slip fault with the dip angel of 20 degrees in an elastic layer with thickness of 40 km overriding a Maxwell viscoelastic half layer with the relaxation time of 5 yrs. In a test model where we set the fault at 30-40 km depths, the recurrence time of the EQ cycle is reduced by 1 yr from 27.92 in elastic case to 26.85 yrs. This smaller recurrence time is the same as in Kato (2002), but the effect of the viscoelasticity on the cycles would be larger in the dip-slip fault case than that in the strike-slip one.

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.

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.

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

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.

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.

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.

Characterisation of irradiated thin silicon sensors for the CMS phase II pixel upgrade

DOE PAGES

Adam, W.; Bergauer, T.; Brondolin, E.; ...

2017-08-22

The high luminosity upgrade of the Large Hadron Collider, foreseen for 2026, necessitates the replacement of the CMS experiment’s silicon tracker. The innermost layer of the new pixel detector will be exposed to severe radiation, corresponding to a 1 MeV neutron equivalent fluence of up tomore » $$\\Phi _{eq} = 2 \\times 10^{16}$$  cm$$^{-2}$$ , and an ionising dose of $${\\approx } 5$$  MGy after an integrated luminosity of 3000 fb$$^{-1}$$ . Thin, planar silicon sensors are good candidates for this application, since the degradation of the signal produced by traversing particles is less severe than for thicker devices. Here in this article, the results obtained from the characterisation of 100 and 200 μm thick p-bulk pad diodes and strip sensors irradiated up to fluences of $$\\Phi _{eq} = 1.3 \\times 10^{16}$$  cm$$^{-2}$$ are shown.« less

Brain Mass and Encephalization Quotients in the Domestic Industrial Pig (Sus scrofa)

PubMed Central

Minervini, Serena; Accogli, Gianluca; Pirone, Andrea; Graïc, Jean-Marie; Cozzi, Bruno; Desantis, Salvatore

2016-01-01

In the present study we examined the brain of fetal, newborn, and adult pigs raised for meat production. The fresh and formalin-fixed weights of the brain have been recorded and used, together with body weight, to calculate the Encephalization Quotient (EQ). The weight of the cerebellum has been used to calculate the Cerebellar Quotient (CQ). The results have been discussed together with analogue data obtained in other terrestrial Cetartiodactyla (including the domestic bovine, sheep, goat, and camel), domesticated Carnivora, Proboscidata, and Primates. Our study, based on a relatively large experimental series, corrects former observations present in the literature based on smaller samples, and emphasizes that the domestic pig has a small brain relative to its body size (EQ = 0.38 for adults), possibly due to factors linked to the necessity of meat production and improved body weight. Comparison with other terrestrial Cetartiodactyla indicates a similar trend for all domesticated species. PMID:27351807

Reversal of bedrest-induced orthostatic intolerance by lower body negative pressure and saline

NASA Technical Reports Server (NTRS)

Hyatt, K. H.; West, D. A.

1977-01-01

Six healthy male volunteers underwent two 1-week periods of bedrest, each preceded and followed by 2-week control and recovery periods. The daily metabolic diet contained 150 mEq of sodium. Following one 7-day bedrest period, each man was subjected to LBNP at a level of -30 mm Hg for 4 hr while consuming 1000 ml of beef bouillon containing 154 mEq of sodium. After the other bedrest period, each man simply consumed the bouillon without LBNP treatment during 4 hr of continued bedrest. Measurements of plasma volume and orthostatic tolerance were made before and after each treatment period. After combined LBNP and saline therapy, plasma volume and response to LBNP testing showed a return to pre-bedrest levels. Saline consumption alone had a lesser effect. With continuation of bedrest in three subjects, the beneficial effects of these measures appeared to be largely gone after 18 hr.

Difference in serum magnesium level among patients with stable chronic obstructive pulmonary disease (COPD) and exacerbated COPD

NASA Astrophysics Data System (ADS)

Sanowara, R.; Keliat, E. N.; Abidin, A.

2018-03-01

Stable COPD is marked with various degrees of inflammation throughout large and small airways also in the alveoli which cause mucus hypersecretion, narrowing of the airway, and alveoli damage. Exacerbation is an episode of elevated inflammation. The relation between inflammation response and magnesium has been observed with the increase of proinflammation cytokines in magnesium deficiency. A cross-sectional study of 34 patients who came to RSUP H. Adam Malik (17 stable COPD patients and 17 acute exacerbated COPD patients) was conducted to examine serum magnesium level and spirometry in stable condition. Mean serum magnesium level for stable COPD patients group was 2.09 ± 0.11 mEq/L. It was higher than in the exacerbated COPD patients group 1.69 ± 0.27 mEq/L. Mann–Whitney statistical analysis showed a significant difference in magnesium level between stable COPD and exacerbated COPD groups (p<0.05).

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

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.

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.

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.

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.

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.

Agreement Between Bioelectrical Impedance and Dual-Energy X-Ray Absorptiometry to Track Changes in Fat-Free Mass After Resistance Training in Older Women.

PubMed

Nascimento, Matheus A; Silva, Danilo R P; Ribeiro, Alex S; Pina, Fábio L C; Gerage, Aline M; Gobbo, Luís A; Mayhew, Jerry L; Cyrino, Edilson S

2018-05-23

Nascimento, MA, Silva, DRP, Ribeiro, AS, Pina, FLC, Gerage, AM, Gobbo, LA, Mayhew, JL, and Cyrino, ES. Agreement between bioelectrical impedance and dual-energy x-ray absorptiometry to track changes in fat-free mass after resistance training in older women. J Strength Cond Res XX(X): 000-000, 2018-The aim of our study was to compare the agreement between bioelectrical impedance (BIA) and dual-energy X-ray absorptiometry (DXA) to track changes on fat-free mass (FFM) after a resistance training (RT) program in older women. Forty-three older women (65.2 ± 4.6 years, 59.5 ± 9.2 kg, 156.4 ± 6.0 cm, 24.3 ± 3.3 kg·m) participated in a RT intervention (12 weeks, 8 exercises, 2 sets, 10-15 repetitions, 3 nonconsecutive days per week). Fat-free mass changes were determined by a single-frequency BIA device (EQ1), 6 BIA prediction equations for older women (EQ2, EQ3, EQ4, EQ5, EQ6, and EQ7), and DXA. At pretraining, 3 equations overpredicted, and 3 underpredicted DXA FFM (F = 244.63, p < 0.001), although all equations had high correlations with DXA (r = 0.78-0.83). After training, 4 equations overpredicted and one underpredicted DXA FFM (F = 176.25, p < 0.001). Dual-energy X-ray absorptiometry detected significant gains in FFM (0.65 ± 0.82 kg; p < 0.05), as did EQ3 (0.55 ± 1.69 kg; p < 0.05), and EQ4 (0.61 ± 1.88 kg; p < 0.05), whereas the remaining equations did not indicate significant changes in FFM. Low correlations between FFM and equation change values suggest that single-frequency BIA-derived equations may not provide sufficient accuracy to track changes in FFM after 12 weeks of RT in older women.

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.

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.

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

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

Quantum 1/f Noise in Solid-State Devices in Particular Hg(1-x)Cd(x)Te N(+)-p Diodes

DTIC Science & Technology

1991-08-01

associated with the burst noise, it is inconceivable that we are dealing . MECHANISMS OF BURST NOISE with the statistics of a large number of carriers. It...below the direct derivation for this example. Multiplying Eq. (D15) with ba*(k,t-,t) and taking the average over a statistical ensemble which

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 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.

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

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.

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.

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.

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.

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.

Environmental analysis of a construction and demolition waste recycling plant in Portugal--Part I: energy consumption and CO2 emissions.

PubMed

Coelho, André; de Brito, Jorge

2013-05-01

This work is a part of a wider study involving the economic and environmental implications of managing construction and demolition waste (CDW), focused on the operation of a large scale CDW recycling plant. This plant, to be operated in the Lisbon Metropolitan Area (including the Setúbal peninsula), is analysed for a 60 year period, using primary energy consumption and CO2eq emission impact factors as environmental impact performance indicators. Simplified estimation methods are used to calculate industrial equipment incorporated, and the operation and transport related impacts. Material recycling--sorted materials sent to other industries, to act as input--is taken into account by discounting the impacts related to industrial processes no longer needed. This first part focuses on calculating the selected impact factors for a base case scenario (with a 350 tonnes/h installed capacity), while a sensitivity analysis is provided in part two. Overall, a 60 year global primary energy consumption of 71.4 thousand toe (tonne of oil equivalent) and a total CO2eq emission of 135.4 thousand tonnes are expected. Under this operating regime, around 563 thousand toe and 1465 thousand tonnes CO2eq could be prevented by replacing raw materials in several construction materials industries (e.g.: ferrous and non-ferrous metals, plastics, paper and cardboard). Copyright © 2013 Elsevier Ltd. All rights reserved.

Life cycle assessment of mobility options using wood based fuels--comparison of selected environmental effects and costs.

PubMed

Weinberg, Jana; Kaltschmitt, Martin

2013-12-01

An environmental assessment and a cost analysis were conducted for mobility options using electricity, hydrogen, ethanol, Fischer-Tropsch diesel and methane derived from wood. Therefore, the overall life cycle with regard to greenhouse gas emissions, acidifying emissions and fossil energy demand as well as costs is analysed. The investigation is carried out for mobility options in 2010 and gives an outlook to the year 2030. Results show that methane utilization in the car is beneficial with regard to environmental impacts (e.g. 58.5 g CO2-eq./km) and costs (23.1 €-ct./km) in 2010, especially in comparison to hydrogen usage (132.4 g CO2-eq./km and 63.9 €-ct./km). The electric vehicle construction has high environmental impacts and costs compared to conventional vehicles today, but with technical improvements and further market penetration, battery electric vehicles can reach the level of concepts with combustion engines in future applications (e.g. cost decrease from 38.7 to 23.4 €-ct./km). Copyright © 2013 Elsevier Ltd. All rights reserved.

Greenhouse gas emissions from different municipal solid waste management scenarios in China: Based on carbon and energy flow analysis.

PubMed

Liu, Yili; Sun, Weixin; Liu, Jianguo

2017-10-01

Waste management is a major source of global greenhouse gas (GHG) emissions and many opportunities exist to reduce these emissions. To identify the GHG emissions from waste management in China, the characteristics of MSW and the current and future treatment management strategies, five typical management scenarios were modeled by EaseTech software following the principles of life cycle inventory and analyzed based on the carbon and energy flows. Due to the high organic fraction (50-70%) and moisture content (>50%) of Chinese municipal solid waste (MSW), the net GHG emissions in waste management had a significant difference from the developed countries. It was found that the poor landfill gas (LFG) collection efficiency and low carbon storage resulted landfilling with flaring and landfilling with biogas recovery scenarios were the largest GHG emissions (192 and 117 kgCO 2 -Eq/t, respectively). In contrast, incineration had the best energy recovery rate (19%), and, by grid emissions substitution, led to a substantial decrease in net GHG emissions (-124 kgCO 2 -Eq/t). Due to the high energy consumption in operation, the unavoidable leakage of CH 4 and N 2 O in treatment, and the further release of CH 4 in disposing of the digested residue or composted product, the scenarios with biological treatment of the organic fractions after sorting, such as composting or anaerobic digestion (AD), did not lead to the outstanding GHG reductions (emissions of 32 and -36 kgCO 2 -Eq/t, respectively) as expected. Copyright © 2017. Published by Elsevier Ltd.

Autism beyond diagnostic categories: characterization of autistic phenotypes in schizophrenia.

PubMed

Kästner, Anne; Begemann, Martin; Michel, Tanja Maria; Everts, Sarah; Stepniak, Beata; Bach, Christiane; Poustka, Luise; Becker, Joachim; Banaschewski, Tobias; Dose, Matthias; Ehrenreich, Hannelore

2015-05-13

Behavioral phenotypical continua from health to disease suggest common underlying mechanisms with quantitative rather than qualitative differences. Until recently, autism spectrum disorders and schizophrenia were considered distinct nosologic entities. However, emerging evidence contributes to the blurring of symptomatic and genetic boundaries between these conditions. The present study aimed at quantifying behavioral phenotypes shared by autism spectrum disorders and schizophrenia to prepare the ground for biological pathway analyses. Specific items of the Positive and Negative Syndrome Scale were employed and summed up to form a dimensional autism severity score (PAUSS). The score was created in a schizophrenia sample (N = 1156) and validated in adult high-functioning autism spectrum disorder (ASD) patients (N = 165). To this end, the Autism Diagnostic Observation Schedule (ADOS), the Autism (AQ) and Empathy Quotient (EQ) self-rating questionnaires were applied back to back with the newly developed PAUSS. PAUSS differentiated between ASD, schizophrenia and a disease-control sample and substantially correlated with the Autism Diagnostic Observation Schedule. Patients with ADOS scores ≥12 obtained highest, those with scores <7 lowest PAUSS values. AQ and EQ were not found to vary dependent on ADOS diagnosis. ROC curves for ADOS and PAUSS resulted in AuC values of 0.9 and 0.8, whereas AQ and EQ performed at chance level in the prediction of ASD. This work underscores the convergence of schizophrenia negative symptoms and autistic phenotypes. PAUSS evolved as a measure capturing the continuous nature of autistic behaviors. The definition of extreme-groups based on the dimensional PAUSS may permit future investigations of genetic constellations modulating autistic phenotypes.

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

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.

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

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

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.

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.

CT dose equilibration and energy absorption in polyethylene cylinders with diameters from 6 to 55 cm

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

Li, Xinhua; Zhang, Da; Liu, Bob, E-mail: bliu7@mgh.harvard.edu

2015-06-15

Purpose: ICRU Report No. 87 Committee and AAPM Task Group 200 designed a three-sectional polyethylene phantom of 30 cm in diameter and 60 cm in length for evaluating the midpoint dose D{sub L}(0) and its rise-to-the-equilibrium curve H(L) = D{sub L}(0)/D{sub eq} from computed tomography (CT) scanning, where D{sub eq} is the equilibrium dose. To aid the use of the phantom in radiation dose assessment and to gain an understanding of dose equilibration and energy absorption in polyethylene, the authors evaluated the short (20 cm) to long (60 cm) phantom dose ratio with a polyethylene diameter of 30 cm, assessedmore » H(L) in polyethylene cylinders of 6–55 cm in diameters, and examined energy absorption in these cylinders. Methods: A GEANT4-based Monte Carlo program was used to simulate the single axial scans of polyethylene cylinders (diameters 6–55 cm and length 90 cm, as well as diameter 30 cm and lengths 20 and 60 cm) on a clinical CT scanner (Somatom Definition dual source CT, Siemens Healthcare). Axial dose distributions were computed on the phantom central and peripheral axes. An average dose over the central 23 or 100 mm region was evaluated for modeling dose measurement using a 0.6 cm{sup 3} thimble chamber or a 10 cm long pencil ion chamber, respectively. The short (20 cm) to long (90 cm) phantom dose ratios were calculated for the 30 cm diameter polyethylene phantoms scanned at four tube voltages (80–140 kV) and a range of beam apertures (1–25 cm). H(L) was evaluated using the dose integrals computed with the 90 cm long phantoms. The resultant H(L) data were subsequently used to compute the fraction of the total energy absorbed inside or outside the scan range (E{sub in}/E or E{sub out}/E) on the phantom central and peripheral axes, where E = LD{sub eq} was the total energy absorbed along the z axis. Results: The midpoint dose in the 60 cm long polyethylene phantom was equal to that in the 90 cm long polyethylene phantom. The short-to-long phantom dose ratios changed with beam aperture and phantom axis but were insensitive to tube voltage. H(L) was insensitive to tube voltage and CT scanner model. As phantom diameter increased from 6 to 55 cm, E{sub in}/E generally decreased but asymptotically approached constant levels on the peripheral axes of large phantoms. The curve of E{sub in}/E versus scan length was almost identical to that of H(L). Similarly, E{sub out}/E increased with scan length and asymptotically approached the equilibrium for large scan lengths. E{sub out}/D{sub eq} was much less than the equilibrium length L{sub eq} where H(L) = 0.98, even with scan lengths much larger than L{sub eq}. Conclusions: The polyethylene phantom designed by ICRU Report No. 87 Committee and AAPM Task Group 200 is adequately long for assessing the midpoint dose and its equilibration in CT scanning. The short-to-long phantom dose ratios and the H(L) data provided in this paper allow easy evaluations of the midpoint dose, longitudinal dose distribution, and energy absorption in polyethylene phantoms. The results of dose equilibration and energy absorption presented herein may be insightful for the clinical CT scans with various subject sizes and scan lengths.« less

Trajectory and Mixing Scaling Laws for Confined and Unconfined Transverse Jets

DTIC Science & Technology

2012-05-01

engines , issues of confinement, very large density ratio, and super/transcritical effects complicate the utility of the ...opposite wall at a streamwise position that is one -half pipe diameter downstream of the injection location (termed moderate impaction). This...BD, and Eq. 10 scaling laws are 0.97 and 0.90, respectively. One of the primary effects of the confinement is that the

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.

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

Very Large Rain Drops from 2D Video Disdrometers and Concomitant Polarimetric Radar Observations

NASA Technical Reports Server (NTRS)

Thurai, Merhala; Gatlin, Patrick; Bringi, V. N.; Carey, Lawrence

2014-01-01

Drop size distribution (DSD) measurements using ground-based disdrometers (point measurements) have often been used to derive equations to relate radar observations to the integral rainfall parameters (Atlas et al. 1999, Bringi et al., 2003, Kozu et al., 2006, Tokay and Short, 1996, Ajayi and Owolabi, 1987, Battan, 1973). Disdrometers such as JWD, MRR and several others have a major limitation in measuring drops with equi-volume diameters (D(sub eq)) larger than 5 mm because they often rely on the velocity-diameter relationship which plateaus beyond this diameter range (Atlas et al., 1973, Gunn & Kinzer, 1949). Other disdrometers such as Parsivel also lack accuracy beyond this diameter range. The 2D video disdrometer (2DVD: Schönhuber et al., 2008) on the other hand gives drop-shape contours and velocities for each individual drop/hydrometeor falling through its sensor area; this provides a unique opportunity to study the role of very-large drops on radar measurements in particular those with polarimetric radar capability where DSDs with a significant component of very large drops may require special consideration given that the differential reflectivity and other polarimetric radar parameters including attenuation-correction methods will be sensitive to the concentrations of these large drops. A recent study on the occurrence of large drops by Gatlin et al. (2014) has compiled a large and diverse set of measurements made with the 2D video disdrometers from many locations around the globe. Some of the largest drops found in this study were 9 mm D(sub eq) and larger, and in this paper, we report on three such events, with maximum D(sub eq's) of 9.0, 9.1 and 9.7 mm, which occurred in Colorado, Northern Alabama, and Oklahoma, respectively. Detailed examination of the 2DVD data - in terms of shapes and fall velocities - has confirmed that these are fully-melted hydrometeors, although for the last case in Oklahoma, a bigger and non-fully-melted hydrometeor was also observed. All three events were also captured by polarimetric radars, namely the S-band CHILL radar operated by Colorado State University (Brunkow et al., 2000), the C-band ARMOR radar (Petersen et al., 2007) operated by University of Alabama in Huntsville, and NEXRADKVNX, operated by the US National Weather Service, respectively. For the last event, several other radar observations were also made, including two X-band radars operated by the US Dept. of Energy. Analyses of 2DVD data in conjunction with the corresponding radar observations are presented, along with some discussion on sampling issues related to the measurements of such large rain drops. The latter is addressed using maximum diameter D(sub max) measurements from 1-minute DSDs using two collocated 2DVDs for 37 events in Huntsville.

Statistics of extreme waves in the framework of one-dimensional Nonlinear Schrodinger Equation

NASA Astrophysics Data System (ADS)

Agafontsev, Dmitry; Zakharov, Vladimir

2013-04-01

We examine the statistics of extreme waves for one-dimensional classical focusing Nonlinear Schrodinger (NLS) equation, iΨt + Ψxx + |Ψ |2Ψ = 0, (1) as well as the influence of the first nonlinear term beyond Eq. (1) - the six-wave interactions - on the statistics of waves in the framework of generalized NLS equation accounting for six-wave interactions, dumping (linear dissipation, two- and three-photon absorption) and pumping terms, We solve these equations numerically in the box with periodically boundary conditions starting from the initial data Ψt=0 = F(x) + ?(x), where F(x) is an exact modulationally unstable solution of Eq. (1) seeded by stochastic noise ?(x) with fixed statistical properties. We examine two types of initial conditions F(x): (a) condensate state F(x) = 1 for Eq. (1)-(2) and (b) cnoidal wave for Eq. (1). The development of modulation instability in Eq. (1)-(2) leads to formation of one-dimensional wave turbulence. In the integrable case the turbulence is called integrable and relaxes to one of infinite possible stationary states. Addition of six-wave interactions term leads to appearance of collapses that eventually are regularized by the dumping terms. The energy lost during regularization of collapses in (2) is restored by the pumping term. In the latter case the system does not demonstrate relaxation-like behavior. We measure evolution of spectra Ik =< |Ψk|2 >, spatial correlation functions and the PDFs for waves amplitudes |Ψ|, concentrating special attention on formation of "fat tails" on the PDFs. For the classical integrable NLS equation (1) with condensate initial condition we observe Rayleigh tails for extremely large waves and a "breathing region" for middle waves with oscillations of the frequency of waves appearance with time, while nonintegrable NLS equation with dumping and pumping terms (2) with the absence of six-wave interactions α = 0 demonstrates perfectly Rayleigh PDFs without any oscillations with time. In case of the cnoidal wave initial condition we observe severely non-Rayleigh PDFs for the classical NLS equation (1) with the regions corresponding to 2-, 3- and so on soliton collisions clearly seen of the PDFs. Addition of six-wave interactions in Eq. (2) for condensate initial condition results in appearance of non-Rayleigh addition to the PDFs that increase with six-wave interaction constant α and disappears with the absence of six-wave interactions α = 0. References: [1] D.S. Agafontsev, V.E. Zakharov, Rogue waves statistics in the framework of one-dimensional Generalized Nonlinear Schrodinger Equation, arXiv:1202.5763v3.

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

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.

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.

Outcomes in Severe Hyponatremia Treated With and Without Desmopressin.

PubMed

MacMillan, Thomas E; Cavalcanti, Rodrigo B

2018-03-01

Overcorrection of plasma sodium in severe hyponatremia is associated with osmotic demyelination syndrome. Desmopressin (DDAVP) can prevent overcorrection of plasma sodium in hyponatremia. The objective of this study was to compare outcomes in hyponatremia according to DDAVP usage. This was a retrospective observational study including all admissions to internal medicine with hyponatremia (plasma sodium concentration <123 mEq/L) from 2004 to 2014 at 2 academic hospitals in Toronto, Canada. The primary outcome was safe sodium correction (≤12 mEq/L in any 24-hour and ≤18 mEq/L in any 48-hour period). We identified 1450 admissions with severe hyponatremia; DDAVP was administered in 254 (17.5%). Although DDAVP reduced the rate of change of plasma sodium, fewer patients in the DDAVP group achieved safe correction (174 of 251 [69.3%] vs 970 of 1164 [83.3%]); this result was driven largely by overcorrection occurring before DDAVP administration in the rescue group. Among patients receiving DDAVP, most received it according to a reactive strategy, whereby DDAVP was given after a change in plasma sodium within correction limits (174 of 254 [68.5%]). Suspected osmotic demyelination syndrome was identified in 4 of 1450 admissions (0.28%). There was lower mortality in the DDAVP group (3.9% vs 9.4%), although this is likely affected by confounding. Length of stay in hospital was longer in those who received DDAVP according to a proactive strategy. Although observational, these data support a reactive strategy for using DDAVP in patients at average risk of osmotic demyelination syndrome, as well as a more stringent plasma sodium correction limit of 8 mEq/L in any 24-hour period for high-risk patients. Further studies are urgently needed on DDAVP use in treating hyponatremia. Copyright © 2018 Elsevier Inc. All rights reserved.

New insights into agricultural pesticide pollution through a complete and continuous pesticide screening during one growing season in five small Swiss streams

NASA Astrophysics Data System (ADS)

Mangold, Simon; Doppler, Tobias; Spycher, Simon; Langer, Miriam; Junghans, Marion; Kunz, Manuel; Stamm, Christian; Singer, Heinz

2017-04-01

Agricultural pesticides are regularly found in many surface waters draining agricultural areas. Due to large fluctuations in concentration over time and the potentially high number of pesticides, it is difficult to obtain a complete overview of the real pollution level. This collaborative project between research, federal and cantonal authorities in Switzerland aimed for a comprehensive assessment of pesticide pollution in five small agricultural streams to tackle this knowledge gap. The five streams are located in catchments (1.5 to 9 km2) with intensive agriculture covering a wide range of crops including vegetables, vineyards and orchards. Twelve-hour composite samples were collected continuously from March until the end of August 2015 with automatic sampling devices, yielding 360 samples per site. Using precipitation and water level data, we differentiated between discharge events and low-flow periods. Samples from discharge events where measured individually whereas samples taken during dry weather were pooled for the analysis. This procedure resulted in a complete concentration profile over the entire monitoring period covered by 34 - 60 samples per site. The analysis, using liquid chromatography coupled to high resolution mass spectrometry involved a target screening of about 220 pesticides. The measured concentrations were compared to chronic and acute environmental quality standards (EQS values) resulting in risk quotients RQs, which are the ratios between measured concentrations and the respective EQS values. Despite the small size of the catchments, we observed a large pesticide diversity in all of them with 68 to 103 detected compounds per study area. At all sites, chronic EQS values were exceeded. However, the exposure levels varied substantially among catchments. Maximum chronic RQs per site ranged between 1.1 and 48.8 and the duration of EQS exceedance varied between 2 weeks and 5.5 months. Additionally, the data reveal (very) high concentration peaks reaching up to 40 μg L-1 for single active ingredients. Of 15 compounds measured at high concentrations, several measured concentrations exceeded acute EQS values in three of the five areas for a duration of up to 2.5 months. Concentration peaks were often linked to discharge events but not exclusively. These findings demonstrate that rain driven processes were important causes of the observed concentration levels but that additional (possibly point) sources need to be considered for a comprehensive understanding of pesticide exposure. Overall, the results from these five catchments provide an unique insight into the diversity of pesticide pollution of small streams across a wide range of natural conditions in Switzerland. The spatial differences indicate that the intensity of pesticide use alone cannot explain the level of exposure but point to the influence of landscape characteristics such as topography, the connectivity of field to the stream network or the number of connected farmyards.

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

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

The carbon footprints of home and in-center maintenance hemodialysis in the United Kingdom.

PubMed

Connor, Andrew; Lillywhite, Robert; Cooke, Matthew W

2011-01-01

Climate change presents a global health threat. However, the provision of healthcare, including dialysis, is associated with greenhouse gas emissions. The aim of this study was to determine the carbon footprints of the differing modalities and treatment regimes used to deliver maintenance hemodialysis (HD), in order to inform carbon reduction strategies at the level of both individual treatments and HD programs. This was a component analysis study adhering to PAS2050. Emissions factors were applied to data that were collected for building energy use, travel and procurement. Thrice weekly in-center HD has a carbon footprint of 3.8 ton CO2 Eq per patient per year. The majority of emissions arise within the medical equipment (37%), energy use (21%), and patient travel (20%) sectors. The carbon footprint of providing home HD varies with the regime. For standard machines: 4 times weekly (4 days, 4.5 hours), 4.3 ton CO2 Eq; 5 times weekly (5 days, 4 hours), 5.1 ton CO2 Eq ; short daily (6 days, 2 hours), 5.2 ton CO2 Eq; nocturnal (3 nightly, 7 hours), 3.9 ton CO2 Eq; and nocturnal (6 nightly, 7 hours), 7.2 ton CO2 Eq. For NxStage equipment: short daily (5.5 days, 3 hours), 1.8 ton CO2 Eq; 6 nightly nocturnal (2.1 ton CO2 Eq). The carbon footprint of HD is influenced more by the frequency of treatments than by their duration. The anticipated rise in the prevalence of home HD patients, dialyzing more frequently and for longer than in-center patients, will increase the emissions associated with HD programs (despite reductions in patient travel emissions). Emerging technologies, such as NxStage, might offer a solution to this problem. © 2011 The Authors. Hemodialysis International © 2011 International Society for Hemodialysis.

Global spatially explicit CO2 emission metrics at 0.25° horizontal resolution for forest bioenergy

NASA Astrophysics Data System (ADS)

Cherubini, F.

2015-12-01

Bioenergy is the most important renewable energy option in studies designed to align with future RCP projections, reaching approximately 250 EJ/yr in RCP2.6, 145 EJ/yr in RCP4.5 and 180 EJ/yr in RCP8.5 by the end of the 21st century. However, many questions enveloping the direct carbon cycle and climate response to bioenergy remain partially unexplored. Bioenergy systems are largely assessed under the default climate neutrality assumption and the time lag between CO2 emissions from biomass combustion and CO2 uptake by vegetation is usually ignored. Emission metrics of CO2 from forest bioenergy are only available on a case-specific basis and their quantification requires processing of a wide spectrum of modelled or observed local climate and forest conditions. On the other hand, emission metrics are widely used to aggregate climate impacts of greenhouse gases to common units such as CO2-equivalents (CO2-eq.), but a spatially explicit analysis of emission metrics with global forest coverage is today lacking. Examples of emission metrics include the global warming potential (GWP), the global temperature change potential (GTP) and the absolute sustained emission temperature (aSET). Here, we couple a global forest model, a heterotrophic respiration model, and a global climate model to produce global spatially explicit emission metrics for CO2 emissions from forest bioenergy. We show their applications to global emissions in 2015 and until 2100 under the different RCP scenarios. We obtain global average values of 0.49 ± 0.03 kgCO2-eq. kgCO2-1 (mean ± standard deviation), 0.05 ± 0.05 kgCO2-eq. kgCO2-1, and 2.14·10-14 ± 0.11·10-14 °C (kg yr-1)-1, and 2.14·10-14 ± 0.11·10-14 °C (kg yr-1)-1 for GWP, GTP and aSET, respectively. We also present results aggregated at a grid, national and continental level. The metrics are found to correlate with the site-specific turnover times and local climate variables like annual mean temperature and precipitation. Simplified equations are derived to infer metric values from the turnover time of the biomass feedstock and the fraction of forest residues left on site after harvest. Our results provide a basis for assessing CO2 emissions from forest bioenergy under different indicators and across various spatial and temporal scales.

Designing Ordered Molecular Arrays in Two and Three Dimensions

DTIC Science & Technology

1991-12-01

components often form 1:1 cocrystals (eq 1). These crystals are interesting for two R. R, H2. H H .R. N’.Hl H,.H𔃺 0 1 ’N ’N NH N N. NN No N .0’N N...and M. 35 Most seem to form 1:1 micro- cocrystals , most of which are not large enough for single- crystal diffractometry. Nonetheless, we have been able

Characterization of irradiated APDs for picosecond time measurements

NASA Astrophysics Data System (ADS)

Centis Vignali, M.; Dalal, R.; Gallinaro, M.; Harrop, B.; Jain, G.; Lu, C.; McClish, M.; McDonald, K. T.; Moll, M.; Newcomer, F. M.; Ugobono, S. Otero; White, S.

2018-01-01

For their operation at the CERN High Luminosity Large Hadron Collider (HL-LHC), the ATLAS and CMS experiments are planning to implement dedicated systems to measure the time of arrival of minimum ionizing particles with an accuracy of about 30 ps. The timing detectors will be subjected to radiation levels corresponding up to a 1-MeV neutrons fluence (Φeq) of 1015 cm-2 for the goal integrated luminosity of HL-LHC of 3000 fb-1. In this paper, deep-diffused Avalanche Photo Diodes (APDs) produced by Radiation Monitoring Devices are examined as candidate timing detectors for HL-LHC applications. These APDs are operated at 1.8 kV, resulting in a gain of up to 500. The timing performance of the detectors is evaluated using a pulsed laser. The effects of radiation damage on current, signal amplitude, noise, and timing performance of the APDs are evaluated using detectors irradiated with neutrons up to Φeq = 1015 cm-2.

Effects of Parameter Uncertainty on Long-Term Simulations of Lake Alkalinity

NASA Astrophysics Data System (ADS)

Lee, Sijin; Georgakakos, Konstantine P.; Schnoor, Jerald L.

1990-03-01

A first-order second-moment uncertainty analysis has been applied to two lakes in the Adirondack Park, New York, to assess the long-term response of lakes to acid deposition. Uncertainty due to parameter error and initial condition error was considered. Because the enhanced trickle-down (ETD) model is calibrated with only 3 years of field data and is used to simulate a 50-year period, the uncertainty in the lake alkalinity prediction is relatively large. When a best estimate of parameter uncertainty is used, the annual average alkalinity is predicted to be -11 ±28 μeq/L for Lake Woods and 142 ± 139 μeq/L for Lake Panther after 50 years. Hydrologic parameters and chemical weathering rate constants contributed most to the uncertainty of the simulations. Results indicate that the uncertainty in long-range predictions of lake alkalinity increased significantly over a 5- to 10-year period and then reached a steady state.

Acute quadriplegia from hyperkalemia: a case report and literature review.

PubMed

Panichpisal, Kessarin; Gandhi, Shefali; Nugent, Kenneth; Anziska, Yaacov

2010-11-01

Hyperkalemia has been described as a rare and under recognized cause of acute quadriplegia. A 52-year-old man with end-stage renal disease presented with ascending quadriplegia and dyspnea for 2 days. He had life-threatening hyperkalemia (9.0 mEq/L). His electrocardiogram showed typical features of hyperkalemia. His symptoms improved in 30 minutes and completely resolved in 5 hours after emergent treatment of hyperkalemia. He admitted eating large amounts of high potassium foods and taking ibuprofen in uncertain quantities. We reviewed 62 articles and identified 73 patients with secondary hyperkalemic paralysis. Common presentations were diminished reflexes, quadriparesis/paralysis, respiratory involvement, and sensory loss. Almost half of all patients had potassium levels higher than 9 mEq/L. Complete recovery, achieved in 89% of patients, did not correlate either with the absolute potassium level or the degree to which it was corrected. Hyperkalemia is a rare but treatable cause of acute flaccid paralysis that requires immediate treatment. Late diagnosis can delay appropriate treatment leading to cardiac arrhythmias and arrest.

Multivariate Meta-Analysis of Brain-Mass Correlations in Eutherian Mammals

PubMed Central

Steinhausen, Charlene; Zehl, Lyuba; Haas-Rioth, Michaela; Morcinek, Kerstin; Walkowiak, Wolfgang; Huggenberger, Stefan

2016-01-01

The general assumption that brain size differences are an adequate proxy for subtler differences in brain organization turned neurobiologists toward the question why some groups of mammals such as primates, elephants, and whales have such remarkably large brains. In this meta-analysis, an extensive sample of eutherian mammals (115 species distributed in 14 orders) provided data about several different biological traits and measures of brain size such as absolute brain mass (AB), relative brain mass (RB; quotient from AB and body mass), and encephalization quotient (EQ). These data were analyzed by established multivariate statistics without taking specific phylogenetic information into account. Species with high AB tend to (1) feed on protein-rich nutrition, (2) have a long lifespan, (3) delayed sexual maturity, and (4) long and rare pregnancies with small litter sizes. Animals with high RB usually have (1) a short life span, (2) reach sexual maturity early, and (3) have short and frequent gestations. Moreover, males of species with high RB also have few potential sexual partners. In contrast, animals with high EQs have (1) a high number of potential sexual partners, (2) delayed sexual maturity, and (3) rare gestations with small litter sizes. Based on these correlations, we conclude that Eutheria with either high AB or high EQ occupy positions at the top of the network of food chains (high trophic levels). Eutheria of low trophic levels can develop a high RB only if they have small body masses. PMID:27746724

Trade-offs between high yields and greenhouse gas emissions in irrigation wheat cropland in China

NASA Astrophysics Data System (ADS)

Cui, Z. L.; Wu, L.; Ye, Y. L.; Ma, W. Q.; Chen, X. P.; Zhang, F. S.

2014-04-01

Although the concept of producing higher yields with reduced greenhouse gas (GHG) emissions is a goal that attracts increasing public and scientific attention, the trade-off between high yields and GHG emissions in intensive agricultural production is not well understood. Here, we hypothesize that there exists a mechanistic relationship between wheat grain yield and GHG emission, and that could be transformed into better agronomic management. A total 33 sites of on-farm experiments were investigated to evaluate the relationship between grain yield and GHG emissions using two systems (conventional practice, CP; high-yielding systems, HY) of intensive winter wheat (Triticum aestivum L.) in China. Furthermore, we discussed the potential to produce higher yields with lower GHG emissions based on a survey of 2938 farmers. Compared to the CP system, grain yield was 39% (2352 kg ha-1) higher in the HY system, while GHG emissions increased by only 10%, and GHG emission intensity was reduced by 21%. The current intensive winter wheat system with farmers' practice had a median yield and maximum GHG emission rate of 6050 kg ha-1 and 4783 kg CO2 eq ha-1, respectively; however, this system can be transformed to maintain yields while reducing GHG emissions by 26% (6077 kg ha-1, and 3555 kg CO2 eq ha-1). Further, the HY system was found to increase grain yield by 39% with a simultaneous reduction in GHG emissions by 18% (8429 kg ha-1, and 3905 kg CO2 eq ha-1, respectively). In the future, we suggest moving the trade-off relationships and calculations from grain yield and GHG emissions to new measures of productivity and environmental protection using innovative management technologies.

Bayesian Analysis of Hot-Jupiter Radius Anomalies: Evidence for Ohmic Dissipation?

NASA Astrophysics Data System (ADS)

Thorngren, Daniel P.; Fortney, Jonathan J.

2018-05-01

The cause of hot-Jupiter radius inflation, where giant planets with {T}eq} > 1000 K are significantly larger than expected, is an open question and the subject of many proposed explanations. Many of these hypotheses postulate an additional anomalous power that heats planets’ convective interiors, leading to larger radii. Rather than examine these proposed models individually, we determine what anomalous powers are needed to explain the observed population’s radii, and consider which models are most consistent with this. We examine 281 giant planets with well-determined masses and radii and apply thermal evolution and Bayesian statistical models to infer the anomalous power as a fraction of (and varying with) incident flux ɛ(F) that best reproduces the observed radii. First, we observe that the inflation of planets below about M = 0.5 M J appears very different than their higher-mass counterparts, perhaps as the result of mass loss or an inefficient heating mechanism. As such, we exclude planets below this threshold. Next, we show with strong significance that ɛ(F) increases with {T}eq} toward a maximum of ∼2.5% at T eq ≈ 1500 K, and then decreases as temperatures increase further, falling to ∼0.2% at T eff = 2500 K. This high-flux decrease in inflation efficiency was predicted by the Ohmic dissipation model of giant planet inflation but not other models. We also show that the thermal tides model predicts far more variance in radii than is observed. Thus, our results provide evidence for the Ohmic dissipation model and a functional form for ɛ(F) that any future theories of hot-Jupiter radii can be tested against.

Preference-based Health status in a German outpatient cohort with multiple sclerosis

PubMed Central

2013-01-01

Background To prospectively determine health status and health utility and its predictors in patients with multiple sclerosis (MS). Methods A total of 144 MS patients (mean age: 41.0 ±11.3y) with different subtypes (patterns of progression) and severities of MS were recruited in an outpatient university clinic in Germany. Patients completed a questionnaire at baseline (n = 144), 6 months (n = 65) and 12 months (n = 55). Health utilities were assessed using the EuroQol instrument (EQ-5D, EQ VAS). Health status was assessed by several scales (Expanded Disability Severity Scale (EDSS), Modified Fatigue Impact Scale (M-FIS), Functional Assessment of MS (FAMS), Beck Depression Inventory (BDI-II) and Multiple Sclerosis Functional Composite (MSFC)). Additionally, demographic and socioeconomic parameters were assessed. Multivariate linear and logistic regressions were applied to reveal independent predictors of health status. Results Health status is substantially diminished in MS patients and the EQ VAS was considerably lower than that of the general German population. No significant change in health-status parameters was observed over a 12-months period. Multivariate analyses revealed M-FIS, BDI-II, MSFC, and EDSS to be significant predictors of reduced health status. Socioeconomic and socio-demographic parameters such as working status, family status, number of household inhabitants, age, and gender did not prove significant in multivariate analyses. Conclusion MS considerably impairs patients’ health status. Guidelines aiming to improve self-reported health status should include treatment options for depression and fatigue. Physicians should be aware of depression and fatigue as co-morbidities. Future studies should consider the minimal clinical difference when health status is a primary outcome. PMID:24089999

In vitro antioxidant and antiproliferative activities of plants of the ethnopharmacopeia from northwest of Mexico

PubMed Central

2013-01-01

Background The aim of this study, is to investigate the in vitro antioxidant activity, the total phenols content, the flavonoids content and the antiproliferative activity of methanolic extracts of the plants: Krameria erecta, Struthanthus palmeri, Phoradendron californicum, Senna covesii and Stegnosperma halimifolium, used by different ethnic groups from northwestern Mexico in the treatment and cure of various diseases. Methods The in vitro antioxidant activity was measured by 2,2-diphenyl-1-picrylhydrazyl (DPPH) and Ferric Reducing/Antioxidant Power assay (FRAP), the total phenols content was measured by Folin–Ciocalteau assay, the flavonoids content by the AlCl3 colorimetric method and the antiproliferative activity (line cells HeLa, RAW 264.7, M12Ak.C3.F6 and L929) using MTT method. Results The K. erecta extract showed the higher radical scavenging activity (67.88%), antioxidant activity by FRAP (1.41 mg Trolox Eq), the highest total phenols content (598.51 mg Galic Acid Eq/g extract), the highest flavonoids content (3.80 mg Quercetin Eq/g extract) and the greatest antiproliferative activity in a dose dependent manner against most Cell line evaluated. A positive correlation was found between the antioxidant activity and the flavonoids content. Conclusions This study is the first report on the antioxidant and antiproliferative activities of the five species evaluated. The results demostrate that there is a positive correlation between antioxidant activity and the flavonoids content, indicating that these type of polyphenols could be the major contributors to the observed antioxidant activity in the evaluated plant extracts. Of the extracts evaluated, that of Krameria erecta showed the greatest antioxidant and antiproliferative activities, a discovery that makes this species a promising candidate for future research. PMID:23305162

Radiation Tests of Single Photon Avalanche Diode for Space Applications

NASA Technical Reports Server (NTRS)

Moscatelli, Francesco; Marisaldi, Martino; MacCagnani, Piera; Labanti, Claudio; Fuschino, Fabio; Prest, Michela; Berra, Alessandro; Bolognini, Davide; Ghioni, Massimo; Rech, Ivan;

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.

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

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.

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.

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

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).

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.

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.

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

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.

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

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

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)(•-)).

Water level, vegetation composition, and plant productivity explain greenhouse gas fluxes in temperate cutover fens after inundation

NASA Astrophysics Data System (ADS)

Minke, Merten; Augustin, Jürgen; Burlo, Andrei; Yarmashuk, Tatsiana; Chuvashova, Hanna; Thiele, Annett; Freibauer, Annette; Tikhonov, Vitalij; Hoffmann, Mathias

2016-07-01

Peat extraction leaves a land surface with a strong relief of deep cutover areas and higher ridges. Rewetting inundates the deep parts, while less deeply extracted zones remain at or above the water level. In temperate fens the flooded areas are colonized by helophytes such as Eriophorum angustifolium, Carex spp., Typha latifolia or Phragmites australis dependent on water depth. Reeds of Typha and Phragmites are reported as large sources of methane, but data on net CO2 uptake are contradictory for Typha and rare for Phragmites. Here, we analyze the effect of vegetation, water level and nutrient conditions on greenhouse gas (GHG) emissions for representative vegetation types along water level gradients at two rewetted cutover fens (mesotrophic and eutrophic) in Belarus. Greenhouse gas emissions were measured campaign-wise with manual chambers every 2 to 4 weeks for 2 years and interpolated by modelling. All sites had negligible nitrous oxide exchange rates. Most sites were carbon sinks and small GHG sources. Methane emissions generally increased with net ecosystem CO2 uptake. Mesotrophic small sedge reeds with water table around the land surface were small GHG sources in the range of 2.3 to 4.2 t CO2 eq. ha-1 yr-1. Eutrophic tall sedge - Typha latifolia reeds on newly formed floating mats were substantial net GHG emitters in the range of 25.1 to 39.1 t CO2 eq. ha-1 yr. They represent transient vegetation stages. Phragmites reeds ranged between -1.7 to 4.2 t CO2 eq. ha-1 yr-1 with an overall mean GHG emission of 1.3 t CO2 eq. ha-1 yr-1. The annual CO2 balance was best explained by vegetation biomass, which includes the role of vegetation composition and species. Methane emissions were obviously driven by biological activity of vegetation and soil organisms. Shallow flooding of cutover temperate fens is a suitable measure to arrive at low GHG emissions. Phragmites australis establishment should be promoted in deeper flooded areas and will lead to moderate, but variable GHG emissions or even occasional sinks. The risk of large GHG emissions is higher for eutrophic than mesotrophic peatlands. Nevertheless, flooding of eutrophic temperate fens still represents a safe GHG mitigation option because even the hotspot of our study, the floating tall sedge - Typha latifolia reeds, did not exceed the typical range of GHG emissions from drained fen grasslands and the spatially dominant Phragmites australis reed emitted by far less GHG than drained fens.

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.

Dynamics and Thermodynamics of Quantum Crystals Near the Instability Point in the Self-Consistent Phonon Theory

DTIC Science & Technology

2001-01-01

Buckingham (B), Lennard - Jones (LI ) and Morse (M) potential energy parameters of solid helium and neon calculated with the help of experimental data for the...Using the values of potential energy parameters given in Table 1 for the Buckingham (Eq.(3)), Lennard - Jones (Eq.(4)) and the Morse (Eq.(5)) s.c...calculations are performed in terms of the (expm) Buckingham, the (n,m) Lennard - Jones and the (expexp) Morse self-consistent potentials as

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

Analog Fault Diagnosis of Large-Scale Electronic Circuits.

DTIC Science & Technology

1983-08-01

is invertible. Note that Eq. G - Government Expenditure on Goods (26) is in general nonlinear while Equation (27) is and Services linear. The latter...is achieved at the expense of T - Taxes on Income more test points. 4 R = Government Regulator Navid and Willson, Jr., (71 considered the diagnosis...Theoretically, both approaches are still under development and all seem feasible. It is the purpose of this report to compare these two approaches numerically by

Measurement of Deep Levels at InGaAs(P)/InP Heterojunctions

DTIC Science & Technology

1990-04-01

by write Eq. (10) to obtain (for shallow or deep donor traps): VD(O) = VDK + q/K f. N, (x*)(x* -x)dx* -qAx/ o, - + J N,(x)dx J-* +_N,, F(x)dx KFc . N...8217T, P. Andre, 1. N. Patillon, J. L. Gentler, E. P. Menu , D. Moroni, and G. Case 2: Bias sweep frequency large (e,, <Wf~ccw) M. Martin, Int. Symp. GaAs

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.

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.

Influence of self-efficacy and coping on quality of life and social participation after acquired brain injury: a 1-year follow-up study.

PubMed

Brands, Ingrid; Köhler, Sebastian; Stapert, Sven; Wade, Derick; van Heugten, Caroline

2014-12-01

To investigate the relations linking self-efficacy and coping to quality of life (QOL) and social participation and what effect self-efficacy, changes in self-efficacy, and coping style have on long-term QOL and social participation. Prospective clinical cohort study. General hospitals, rehabilitation centers. Patients with newly acquired brain injury (ABI) (N=148) were assessed at baseline (start outpatient rehabilitation or discharge hospital/inpatient rehabilitation; mean time since injury, 15wk) and 1 year later (mean time since injury, 67wk). Not applicable. QOL was measured with the EuroQuol 5D (the EQ-5D index and the EQ-5D visual analog scale [EQ VAS]) and the 9-item Life Satisfaction Questionnaire (LiSat-9), social participation with the modified Frenchay Activities Index, coping with the Coping Inventory for Stressful Situations, and self-efficacy with the Traumatic Brain Injury Self-efficacy Questionnaire. At baseline, self-efficacy moderated the effect of emotion-oriented coping on the EQ-5D index and of avoidance coping on the EQ VAS. Self-efficacy mediated the relation between emotion-oriented coping and LiSat-9. An increase in self-efficacy over time predicted better scores on the EQ-5D index (β=.30), the EQ VAS (β=.49), and LiSat-9 (β=.44) at follow-up. In addition, higher initial self-efficacy (β=.40) predicted higher LiSat-9 scores at follow-up; higher initial emotion-oriented coping (β=-.23) predicted lower EQ VAS scores at follow-up. Higher modified Frenchay Activities Index scores at follow-up were predicted by higher self-efficacy (β=.19) and higher task-oriented coping (β=.14) at baseline (combined R(2)=5.1%). Self-efficacy and coping predict long-term QOL but seem less important in long-term social participation. High self-efficacy protects against the negative effect of emotion-oriented coping. Enhancing self-efficacy in the early stage after ABI may have beneficial long-term effects. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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.

A Coherent vorticity preserving eddy-viscosity correction for Large-Eddy Simulation

NASA Astrophysics Data System (ADS)

Chapelier, J.-B.; Wasistho, B.; Scalo, C.

2018-04-01

This paper introduces a new approach to Large-Eddy Simulation (LES) where subgrid-scale (SGS) dissipation is applied proportionally to the degree of local spectral broadening, hence mitigated or deactivated in regions dominated by large-scale and/or laminar vortical motion. The proposed coherent-vorticity preserving (CvP) LES methodology is based on the evaluation of the ratio of the test-filtered to resolved (or grid-filtered) enstrophy, σ. Values of σ close to 1 indicate low sub-test-filter turbulent activity, justifying local deactivation of the SGS dissipation. The intensity of the SGS dissipation is progressively increased for σ < 1 which corresponds to a small-scale spectral broadening. The SGS dissipation is then fully activated in developed turbulence characterized by σ ≤σeq, where the value σeq is derived assuming a Kolmogorov spectrum. The proposed approach can be applied to any eddy-viscosity model, is algorithmically simple and computationally inexpensive. LES of Taylor-Green vortex breakdown demonstrates that the CvP methodology improves the performance of traditional, non-dynamic dissipative SGS models, capturing the peak of total turbulent kinetic energy dissipation during transition. Similar accuracy is obtained by adopting Germano's dynamic procedure albeit at more than twice the computational overhead. A CvP-LES of a pair of unstable periodic helical vortices is shown to predict accurately the experimentally observed growth rate using coarse resolutions. The ability of the CvP methodology to dynamically sort the coherent, large-scale motion from the smaller, broadband scales during transition is demonstrated via flow visualizations. LES of compressible channel are carried out and show a good match with a reference DNS.

An exploratory, large-scale study of pain and quality of life outcomes in cancer patients with moderate or severe pain, and variables predicting improvement.

PubMed

Maximiano, Constanza; López, Iker; Martín, Cristina; Zugazabeitia, Luis; Martí-Ciriquián, Juan L; Núñez, Miguel A; Contreras, Jorge; Herdman, Michael; Traseira, Susana; Provencio, Mariano

2018-01-01

There have been few large-scale, real world studies in Spain to assess change in pain and quality of life (QOL) outcomes in cancer patients with moderate to severe pain. This study aimed to assess changes on both outcomes after 3 months of usual care and to investigate factors associated with change in QoL. Large, multi-centre, observational study in patients with lung, head and neck, colorectal or breast cancer experiencing a first episode of moderate to severe pain while attending one of the participating centres. QoL was assessed using the EuroQol-5D questionnaire and pain using the Brief Pain Inventory (BPI). Instruments were administered at baseline and after 3 months of follow up. Multivariate analyses were used to assess the impact of treatment factors, demographic and clinical variables, pain and other symptoms on QoL scores. 1711 patients were included for analysis. After 3 months of usual care, a significant improvement was observed in pain and QoL in all four cancer groups (p<0.001). Effect sizes were medium to large on the BPI and EQ-5D Index and Visual Analogue Scale (VAS). Improvements were seen on the majority of EQ-5D dimensions in all patient groups, though breast cancer patients showed the largest gains. Poorer baseline performance status (ECOG) and the presence of anxiety/depression were associated with significantly poorer QOL outcomes. Improvements in BPI pain scores were associated with improved QoL. In the four cancer types studied, pain and QoL outcomes improved considerably after 3 months of usual care. Improvements in pain made a substantial contribution to QoL gains whilst the presence of anxiety and depression and poor baseline performance status significantly constrained improvement.

Effects of oxidised dietary fish oil and high-dose vitamin E supplementation on growth performance, feed utilisation and antioxidant defence enzyme activities of juvenile large yellow croaker (Larmichthys crocea).

PubMed

Wang, Jun; Xu, Houguo; Zuo, Rantao; Mai, Kangsen; Xu, Wei; Ai, Qinghui

2016-05-01

This study was conducted to elucidate the effects of oxidised dietary lipids and high-dose vitamin E (VE) on growth performance and immune responses of large yellow croaker. Juvenile fish (initial average body weight of 7·82 (sem 0·68) g) were fed diets containing either fresh fish oil (fresh diet, peroxide value (POV)=1·72 mEq/kg) or fish oil oxidised to varying degrees (oxidised diets, POV=28·29-104·21 mEq/kg), with or without supplementary 600 mg VE/kg diet, for 10 weeks in floating cages. Growth was significantly lower and feed intake (g/100 g body weight per d) was higher in fish fed the oxidised diet. Supplementation with VE increased the growth of fish fed the oxidised diets, but significantly decreased the growth of fish fed the fresh diet. Hepatosomatic index increased with increasing dietary POV and decreased with VE supplementation. Hepatic catalase activity, superoxide dismutase (SOD) activity and malondialdehyde content were significantly higher in fish fed the oxidised diets, and these values decreased significantly following VE supplementation. However, hepatic SOD activity was enhanced by VE supplementation in fish fed the fresh diet. Air-exposure mortality was significantly increased by dietary POV, and this effect was inhibited by VE supplementation. These results suggest that dietary oxidised fish oil could stimulate the activities of antioxidant defence enzymes in stressed large yellow croaker. High-dose VE supplementation can alleviate oxidative stress of large yellow croaker fed oxidised fish oil, but can exert deleterious effects on fish in the absence of oxidative stress.

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

Mapping the functional assessment of cancer therapy-breast (FACT-B) to the 5-level EuroQoL Group's 5-dimension questionnaire (EQ-5D-5L) utility index in a multi-ethnic Asian population.

PubMed

Cheung, Yin Bun; Luo, Nan; Ng, Raymond; Lee, Chun Fan

2014-12-12

To develop an algorithm for mapping the Functional Assessment of Cancer Therapy-Breast (FACT-B) to the 5-level EuroQoL Group's 5-dimension questionnaire (EQ-5D-5L) utility index. A survey of 238 breast cancer patients in Singapore was conducted. Models using various regression methods with or without recognizing the upper boundary of utility values at 1 were fitted to predict the EQ-5D-5L utility index based on the five subscale scores of the FACT-B. Data from a follow-up survey of these patients were used to validate the results. A model that maps the physical, emotional, functional well-being and the breast cancer concerns subscales of the FACT-B to the EQ-5D-5L utility index was derived. The social well-being subscale was not associated to the utility index. Although theoretical assumptions may not be valid, ordinary least square outperformed other regression methods. The mean predicted utility index within each performance status level at follow-up deviated from the observed mean less than the minimally important difference of EQ-5D for cancer patients. The mapping algorithm converts the FACT-B to the EQ-5D utility index. This enables oncologists, clinical researchers and policy makers to obtain a quantitative utility summary of a patient's health status when only the FACT-B is assessed.

Levels of synthetic antioxidants (ethoxyquin, butylated hydroxytoluene and butylated hydroxyanisole) in fish feed and commercially farmed fish.

PubMed

Lundebye, A-K; Hove, H; Måge, A; Bohne, V J B; Hamre, K

2010-12-01

Several synthetic antioxidants are authorized for use as feed additives in the European Union. Ethoxyquin (EQ) and butylated hydroxytoluene (BHT) are generally added to fish meal and fish oil, respectively, to limit lipid oxidation. The study was conducted to examine the concentrations of EQ, BHT and butylated hydroxyanisole (BHA) in several commercially important species of farmed fish, namely Atlantic salmon, halibut and cod and rainbow trout, as well as concentrations in fish feed. The highest levels of BHT, EQ and BHA were found in farmed Atlantic salmon fillets, and were 7.60, 0.17 and 0.07 mg kg(-1), respectively. The lowest concentrations of the synthetic antioxidants found were in cod. The concentration of the oxidation product ethoxyquin dimer (EQDM) was more than ten-fold higher than the concentration of parent EQ in Atlantic salmon halibut and rainbow trout, whereas this dimer was not detected in cod fillets. The theoretical consumer exposure to the synthetic antioxidants EQ, BHA and BHT from the consumption of farmed fish was calculated. The contribution of EQ from a single portion (300 g) of skinned fillets of the different species of farmed fish would contribute at most 15% of the acceptable daily intake (ADI) for a 60 kg adult. The consumption of farmed fish would not contribute measurably to the intake of BHA; however, a 300 g portion of farmed Atlantic salmon would contribute up to 75% of the ADI for BHT.

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.

Equine Myxovirus Resistance Protein 2 Restricts Lentiviral Replication by Blocking Nuclear Uptake of Capsid Protein.

PubMed

Ji, Shuang; Na, Lei; Ren, Huiling; Wang, Yujie; Wang, Xiaojun

2018-05-09

Human Myxovirus resistance 2 (huMxB) has been shown to be a determinant type I interferon-induced host factor involved in the inhibition of HIV-1 as well as many other primate lentiviruses. This blocking occurs after the reverse transcription of viral RNA and ahead of the integration into the host DNA, which is closely connected to the ability of the protein to bind the viral capsid. To date, Mx2s derived from non-primate animals have shown no capacity for HIV-1 suppression. In this study, we examined the restrictive effect of equine Mx2 (eqMx2) on both the equine infectious anemia virus (EIAV) and HIV-1 and investigated possible mechanisms for its specific function. We demonstrated that IFNα/β upregulates the expression of eqMx2 in equine monocyte-derived macrophages (eMDMs). Overexpression of eqMx2 significantly suppresses the replication of EIAV, HIV-1, and SIVs, but not that of MLV. Knockdown of eqMx2 transcription weakens the inhibition of EIAV replication by type I interferon. Interestingly, immunofluorescence assays suggest that the subcellular localization of eqMx2 changes following virus infection, from being dispersed in the cytoplasm to being accumulated at the nuclear envelope. Furthermore, eqMx2 blocks the nuclear uptake of the proviral genome by binding to the viral capsid. The N-truncated mutant of eqMx2 lost the ability to bind the viral capsid as well as the restriction effect for lentiviruses. These results improve our understanding of the Mx2 protein in non-primate animals. IMPORTANCE Previous research has shown that the antiviral ability of Mx2s is confined to primates, particularly humans. EIAV has been shown to be insensitive to the restriction by human MxB. Here, we described the function of equine Mx2. This protein plays an important role in the suppression of EIAV, HIV-1, and SIVs. The antiviral activity of eqMx2 depends on its subcellular location as well as its capsid binding capacity. Our results showed that following viral infection, eqMx2 changes its original cytoplasmic location and accumulates at the nuclear envelope where it binds to the viral capsid and blocks the nuclear entry of reverse transcribed proviral DNAs. In contrast, huMxB does not bind to the EIAV capsid and shows no EIAV restriction effect. These studies expand our understanding of the function of the equine Mx2 protein. Copyright © 2018 Ji et al.

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.

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

Agricultural peat lands; towards a greenhouse gas sink - a synthesis of a Dutch landscape study

NASA Astrophysics Data System (ADS)

Schrier-Uijl, A. P.; Kroon, P. S.; Hendriks, D. M. D.; Hensen, A.; Van Huissteden, J. C.; Leffelaar, P. A.; Berendse, F.; Veenendaal, E. M.

2013-06-01

It is generally known that managed, drained peatlands act as carbon sources. In this study we examined how mitigation through the reduction of management and through rewetting may affect the greenhouse gas (GHG) emission and the carbon balance of intensively managed, drained, agricultural peatlands. Carbon and GHG balances were determined for three peatlands in the western part of the Netherlands from 2005 to 2008 by considering spatial and temporal variability of emissions (CO2, CH4 and N2O). One area (Oukoop) is an intensively managed grass-on-peatland, including a dairy farm, with the ground water level at an average annual depth of 0.55 m below the soil surface. The second area (Stein) is an extensively managed grass-on-peatland, formerly intensively managed, with a dynamic ground water level at an average annual depth of 0.45 m below the soil surface. The third area is an (since 1998) rewetted former agricultural peatland (Horstermeer), close to Oukoop and Stein, with the average annual ground water level at a depth of 0.2 m below the soil surface. During the measurement campaigns we found that both agriculturally managed sites acted as carbon and GHG sources but the rewetted agricultural peatland acted as a carbon and GHG sink. The terrestrial GHG source strength was 1.4 kg CO2-eq m-2 yr-1 for the intensively managed area and 1.0 kg CO2-eq m-2 yr-1 for the extensively managed area; the unmanaged area acted as a GHG sink of 0.7 kg CO2-eq m-2 yr-1. Water bodies contributed significantly to the terrestrial GHG balance because of a high release of CH4 and the loss of DOC only played a minor role. Adding the farm-based CO2 and CH4 emissions increased the source strength for the managed sites to 2.7 kg CO2-eq m-2 yr-1 for Oukoop and 2.1 kg CO2-eq m-2 yr-1 for Stein. Shifting from intensively managed to extensively managed grass-on-peat reduced GHG emissions mainly because N2O emission and farm-based CH4 emissions decreased. Overall, this study suggests that managed peatlands are large sources of GHG and carbon, but, if appropriate measures are taken they can be turned back into GHG and carbon sinks within 15 yr of abandonment and rewetting.

A Cross-sectional Assessment of Health-related Quality of Life among Patients with Chronic Obstructive Pulmonary Disease.

PubMed

Garcia-Gordillo, Miguel Ángel; Collado-Mateo, Daniel; Olivares, Pedro Rufino; Adsuar, José Carmelo; Merellano-Navarro, Eugenio

2017-08-01

Chronic obstructive pulmonary disease (COPD) is a major cause of mortality characterized by progressive airflow obstruction and inflammation in the airways, which has an impact on health-related quality of life. The EQ-5D-5L is one of the most used preference-based, health-related quality of life questionnaire. The objective of this study was to provide normative values of EQ-5D-5L for Spanish people suffering from COPD. Data were extracted from the Spanish National Health Survey (2011/2012). Overall, 1130 people with COPD participated in this survey. The utility index of EQ-5D-5L and the Visual Analog Scale (VAS) score were defined by gender, region, and age. Mean (SD) EQ-5D-5L utility index and VAS score for Spanish people with COPD were 0.742 (0.309) and 60.466 (21.934) respectively. In general, men reported better health status than women. Ceiling effect of the whole sample was 30.35%. The current study provides normative values of EQ-5D-5L for Spanish people affected by COPD. Ceiling effect was high and better results were observed in men compared with women.

Assessing the guidelines for potassium replacement in pediatric oncology patients receiving amphotericin B.

PubMed

Lafreniere, Janet A; Hamilton, Donald P; Carr, Roxane R

2006-10-01

To examine the practice of potassium chloride (KCl) replacement in pediatric oncology patients receiving amphotericin B (amp-B). A retrospective observational chart review was conducted of patients who received amp-B on the oncology unit between August 2000 and May 2001. A survey was distributed to pediatric oncology pharmacists at other pediatric institutions to assess KCl infusion guidelines across North America. Twenty hypokalemic episodes were identified within 22 patient admissions. Fifty-five percent used KCl replacement (by all combined routes) at rates exceeding the institution's guidelines. Other pediatric institutions varied with respect to the maximum rates and concentration of KCl permitted on non-intensive care units. Based on the data from this review, the KCl administration guidelines for our hospital were changed. We now allow a maximum peripheral line concentration of 60 mEq/L, a maximum central line concentration of 120 mEq/L and a maximum KCl infusion rate of 0.4 mEq/kg/hr without the requirement of a heart monitor. Parenteral Nutrition is now restricted to maximum potassium concentration of 80 mEq/L and fluid-restricted patients are restricted to a maximum concentration of 150 mEq/L.

Analytic and rule-based decision support tool for VDT workstation adjustment and computer accessories arrangement.

PubMed

Rurkhamet, Busagarin; Nanthavanij, Suebsak

2004-12-01

One important factor that leads to the development of musculoskeletal disorders (MSD) and cumulative trauma disorders (CTD) among visual display terminal (VDT) users is their work posture. While operating a VDT, a user's body posture is strongly influenced by the task, VDT workstation settings, and layout of computer accessories. This paper presents an analytic and rule-based decision support tool called EQ-DeX (an ergonomics and quantitative design expert system) that is developed to provide valid and practical recommendations regarding the adjustment of a VDT workstation and the arrangement of computer accessories. The paper explains the structure and components of EQ-DeX, input data, rules, and adjustment and arrangement algorithms. From input information such as gender, age, body height, task, etc., EQ-DeX uses analytic and rule-based algorithms to estimate quantitative settings of a computer table and a chair, as well as locations of computer accessories such as monitor, document holder, keyboard, and mouse. With the input and output screens that are designed using the concept of usability, the interactions between the user and EQ-DeX are convenient. Examples are also presented to demonstrate the recommendations generated by EQ-DeX.

The Possible Effect of Methylphenidate Treatment on Empathy in Children Diagnosed with Attention-Deficit/Hyperactivity Disorder, Both With and Without Comorbid Oppositional Defiant Disorder.

PubMed

Golubchik, Pavel; Weizman, Abraham

2017-06-01

To assess the Empathizing Quotient (EQ) of patients diagnosed with attention-deficit/hyperactivity disorder (ADHD) only or comorbid with oppositional defiant disorder (ODD) and compare the two groups' responses to methylphenidate (MPH) treatment. Fifty-two children (8-18 years) diagnosed with ADHD, 26 of whom were also diagnosed with comorbid ODD (ADHD/ODD), were treated with MPH for 12 weeks. The level of EQ was assessed with the Children's version of the Empathizing Quotient (EQ-C) and the severity of ADHD symptoms with the ADHD Rating Scale (ADHD-RS). Assessments were done at baseline and at end point. A significant increase in EQ scores was obtained in both groups following MPH treatment (p = 0.003 for ADHD/ODD; p = 0.002 for ADHD). Significant correlation was found in the ADHD group between the changes in ADHD-RS and those in EQ, following MPH treatment (p = 0.015), but not in the ADHD/ODD group (p = 0.48). A correlation exists between MPH-related improvement in ADHD symptoms and between more empathy in children with ADHD not comorbid with ODD.

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

Characterizations of Some Fuzzy Prefilters (Filters) in EQ-Algebras

PubMed Central

Xin, Xiao Long; Yang, Yong Wei

2014-01-01

We introduce and study some types of fuzzy prefilters (filters) in EQ-algebras. First, we present several characterizations of fuzzy positive implicative prefilters (filters), fuzzy implicative prefilters (filters), and fuzzy fantastic prefilters (filters). Next, using their characterizations, we mainly consider the relationships among these special fuzzy filters. Particularly, we find some conditions under which a fuzzy implicative prefilter (filter) is equivalent to a fuzzy positive implicative prefilter (filter). As applications, we obtain some new results about classical filters in EQ-algebras and some related results about fuzzy filters in residuated lattices. PMID:24892096

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

Transverse Beam Dynamics in the Modified Betatron.

DTIC Science & Technology

1982-03-01

charge, m is the electron rest mass, and c is the speed of light . Self field effects will modify Eq. (1) however. A nonneutral current ring produces both a...magnetic flux or stream func- tion *P(p.) rA, where A, is the usual vector potential. The equations for 4 and 1 are 17 CHERNJN AND SPRANGLE p-[ l 2 - ( o...8217- 4). (A-21) m m 2 Using Eq. (A-21) in Eq. (A-20) the resulting integrals are elementary. The result, for the vector potential inside the beam is Ask

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

The carbon footprint of cataract surgery.

PubMed

Morris, D S; Wright, T; Somner, J E A; Connor, A

2013-04-01

Climate change is predicted to be one of the largest global health threats of the 21st century. Health care itself is a large contributor to carbon emissions. Determining the carbon footprint of specific health care activities such as cataract surgery allows the assessment of associated emissions and identifies opportunities for reduction. To assess the carbon footprint of a cataract pathway in a British teaching hospital. This was a component analysis study for one patient having first eye cataract surgery in the University Hospital of Wales, Cardiff. Activity data was collected from three sectors, building and energy use, travel and procurement. Published emissions factors were applied to this data to provide figures in carbon dioxide equivalents (CO2eq). The carbon footprint for one cataract operation was 181.8 kg CO2eq. On the basis that 2230 patients were treated for cataracts during 2011 in Cardiff, this has an associated carbon footprint of 405.4 tonnes CO2eq. Building and energy use was estimated to account for 36.1% of overall emissions, travel 10.1% and procurement 53.8%, with medical equipment accounting for the most emissions at 32.6%. This is the first published carbon footprint of cataract surgery and acts as a benchmark for other studies as well as identifying areas for emissions reduction. Within the procurement sector, dialogue with industry is important to reduce the overall carbon footprint. Sustainability should be considered when cataract pathways are designed as there is potential for reduction in all sectors with the possible side effects of saving costs and improving patient care.

The carbon footprint of cataract surgery

PubMed Central

Morris, D S; Wright, T; Somner, J E A; Connor, A

2013-01-01

Background Climate change is predicted to be one of the largest global health threats of the 21st century. Health care itself is a large contributor to carbon emissions. Determining the carbon footprint of specific health care activities such as cataract surgery allows the assessment of associated emissions and identifies opportunities for reduction. Aim To assess the carbon footprint of a cataract pathway in a British teaching hospital. Methods This was a component analysis study for one patient having first eye cataract surgery in the University Hospital of Wales, Cardiff. Activity data was collected from three sectors, building and energy use, travel and procurement. Published emissions factors were applied to this data to provide figures in carbon dioxide equivalents (CO2eq). Results The carbon footprint for one cataract operation was 181.8 kg CO2eq. On the basis that 2230 patients were treated for cataracts during 2011 in Cardiff, this has an associated carbon footprint of 405.4 tonnes CO2eq. Building and energy use was estimated to account for 36.1% of overall emissions, travel 10.1% and procurement 53.8%, with medical equipment accounting for the most emissions at 32.6%. Conclusions This is the first published carbon footprint of cataract surgery and acts as a benchmark for other studies as well as identifying areas for emissions reduction. Within the procurement sector, dialogue with industry is important to reduce the overall carbon footprint. Sustainability should be considered when cataract pathways are designed as there is potential for reduction in all sectors with the possible side effects of saving costs and improving patient care. PMID:23429413

Recycling of glass: accounting of greenhouse gases and global warming contributions.

PubMed

Larsen, Anna W; Merrild, Hanna; Christensen, Thomas H

2009-11-01

Greenhouse gas (GHG) emissions related to recycling of glass waste were assessed from a waste management perspective. Focus was on the material recovery facility (MRF) where the initial sorting of glass waste takes place. The MRF delivers products like cullet and whole bottles to other industries. Two possible uses of reprocessed glass waste were considered: (i) remelting of cullet added to glass production; and (ii) re-use of whole bottles. The GHG emission accounting included indirect upstream emissions (provision of energy, fuels and auxiliaries), direct activities at the MRF and bottle-wash facility (combustion of fuels) as well as indirect downstream activities in terms of using the recovered glass waste in other industries and, thereby, avoiding emissions from conventional production. The GHG accounting was presented as aggregated global warming factors (GWFs) for the direct and indirect upstream and downstream processes, respectively. The range of GWFs was estimated to 0-70 kg CO(2)eq. tonne( -1) of glass waste for the upstream activities and the direct emissions from the waste management system. The GWF for the downstream effect showed some significant variation between the two cases. It was estimated to approximately -500 kg CO(2)-eq. tonne(- 1) of glass waste for the remelting technology and -1500 to -600 kg CO(2)-eq. tonne(-1) of glass waste for bottle re-use. Including the downstream process, large savings of GHG emissions can be attributed to the waste management system. The results showed that, in GHG emission accounting, attention should be drawn to thorough analysis of energy sources, especially electricity, and the downstream savings caused by material substitution.

Results from a preliminary study to develop the quality adjustments for quality adjusted life year values for Trinidad and Tobago.

PubMed

Bailey, H

2013-07-01

No country can afford to provide all necessary healthcare for its citizens, so prioritization among interventions must feature in all health systems. Resources in health should be allocated among interventions/facilities/patients in such a way as to be in line with the objectives of the health system. To achieve this, resource allocation decisions must be informed by the relative contributions that prospective interventions will make to societal health and to costs. Internationally, the EQ-5D based quality adjusted life year (QALY) now dominates this kind of analysis. This paper reports on a pilot study to develop an EQ-5D-3L value set for Trinidad and Tobago based on a protocol that avoids some of the issues that are associated with other approaches to developing such value sets such as the complex elicitation tasks that respondents must carry out, and the large respondent samples required for collecting multiple valuation subset values using blocked designs. An orthogonal discrete choice experiment design was used to elicit a set of choices from a sample of respondents. The choice data were analysed using mixed multinomial logistic regression to produce an internally valid model that predicts well. This paper marks an important milestone in the development of health resource allocation in the Caribbean. It sets out the importance of incorporating the impact of health interventions to inform health resource allocation decisions, describes the elicitation and analysis methods used in the pilot and provides an illustration of the use of the EQ-5D value set.

Determination of tributyltin in whole water matrices under the European Water Framework Directive.

PubMed

Richter, Janine; Fettig, Ina; Philipp, Rosemarie; Jakubowski, Norbert; Panne, Ulrich; Fisicaro, Paola; Alasonati, Enrica

2016-08-12

Monitoring of water quality is important to control water pollution. Contamination of the aquatic system has a large effect on human health and the environment. Under the European Water Framework Directive (WFD) 2000/60/EC and the related directive on environmental quality standards (EQS) in the field of water policy 2008/105/EC, the need for sensitive reference methods was highlighted. Since tributyltin (TBT) is one of the WFD listed priority substances a method was developed which is capable to qualify and quantify the pollutant at the required low WFD EQS of 0.2ngL(-1) in whole water bodies, i.e. in non-filtered water samples with dissolved organic carbon and suspended particulate matter. Therefore special attention was paid on the interaction of TBT with the suspended particulate matter and humic substances to obtain a complete representation of the pollution in surface waters. Different water samples were investigated varying the content of organic dissolved and suspended matter. Quantification was performed using species-specific isotope dilution (SSID) and gas chromatography with inductively coupled plasma mass spectrometry (GC-ICP-MS). Different sample treatment strategies were evaluated and compared. The process of internal standard addition was investigated and optimized, hence the equilibrium between internal standards and matrix is of primary importance to perform accurate SSID. Samples spiked at EQS level were analyzed with a recovery between 95 and 105 %. Additionally real surface water samples were investigated and the TBT concentration for the whole water body was determined and compared with conventional routine analysis method. Copyright © 2016 Elsevier B.V. All rights reserved.

Understanding discontinuation of oral adjuvant endocrine therapy by women with hormone receptor-positive invasive breast cancer nearly 4 years from diagnosis.

PubMed

Bell, Robin J; Fradkin, Pamela; Schwarz, Max; Davis, Susan R

2013-01-01

The aim of this study was to investigate the extent of discontinuation of oral adjuvant endocrine therapy (OAET) in women nearly 4 years from the diagnosis of their first episode of invasive breast cancer and the reasons for such discontinuation. We used a large, prospective cohort study of women who had been diagnosed with their first episode of invasive breast cancer between 2004 and 2006, recruited through a state-based cancer registry. All participants completed an enrollment questionnaire (EQ) within 12 months of diagnosis and annual follow-up questionnaires (FQs) thereafter. The data in this report were obtained from the EQ and the first three FQs. A total of 1,370 women with hormone receptor-positive disease completed the EQ. At the completion of the third FQ nearly 4 years from diagnosis, 1,193 women remained in the study. Use of OAET peaked by 2 years postdiagnosis. At nearly 4 years from diagnosis, 18% of the 1,193 women remaining in the study were not taking OAET. Of these women, just more than half had ceased therapy mainly owing to a range of adverse effects, predominantly estrogen deficiency symptoms, but the remainder (8% of women remaining in the study) had never used OAET. Our study confirms that early discontinuation of OAET due to estrogen deficiency symptoms remains an important issue despite calls for strategies to address this problem. The number of women potentially suitable for OAET but not receiving it was almost as great as the number of those who have discontinued therapy.

Methane and nitrous oxide emissions from livestock agriculture in 16 local administrative districts of Korea.

PubMed

Ji, Eun Sook; Park, Kyu-Hyun

2012-12-01

This study was conducted to evaluate methane (CH4) and nitrous oxide (N2O) emissions from livestock agriculture in 16 local administrative districts of Korea from 1990 to 2030. National Inventory Report used 3 yr averaged livestock population but this study used 1 yr livestock population to find yearly emission fluctuations. Extrapolation of the livestock population from 1990 to 2009 was used to forecast future livestock population from 2010 to 2030. Past (yr 1990 to 2009) and forecasted (yr 2010 to 2030) averaged enteric CH4 emissions and CH4 and N2O emissions from manure treatment were estimated. In the section of enteric fermentation, forecasted average CH4 emissions from 16 local administrative districts were estimated to increase by 4%-114% compared to that of the past except for Daejeon (-63%), Seoul (-36%) and Gyeonggi (-7%). As for manure treatment, forecasted average CH4 emissions from the 16 local administrative districts were estimated to increase by 3%-124% compared to past average except for Daejeon (-77%), Busan (-60%), Gwangju (-48%) and Seoul (-8%). For manure treatment, forecasted average N2O emissions from the 16 local administrative districts were estimated to increase by 10%-153% compared to past average CH4 emissions except for Daejeon (-60%), Seoul (-4.0%), and Gwangju (-0.2%). With the carbon dioxide equivalent emissions (CO2-Eq), forecasted average CO2-Eq from the 16 local administrative districts were estimated to increase by 31%-120% compared to past average CH4 emissions except Daejeon (-65%), Seoul (-24%), Busan (-18%), Gwangju (-8%) and Gyeonggi (-1%). The decreased CO2-Eq from 5 local administrative districts was only 34 kt, which was insignificantly small compared to increase of 2,809 kt from other 11 local administrative districts. Annual growth rates of enteric CH4 emissions, CH4 and N2O emissions from manure management in Korea from 1990 to 2009 were 1.7%, 2.6%, and 3.2%, respectively. The annual growth rate of total CO2-Eq was 2.2%. Efforts by the local administrative offices to improve the accuracy of activity data are essential to improve GHG inventories. Direct measurements of GHG emissions from enteric fermentation and manure treatment systems will further enhance the accuracy of the GHG data. (Key Words: Greenhouse Gas, Methane, Nitrous Oxide, Carbon Dioxide Equivalent Emission, Climate Change).

Reconsidering the use of rankings in the valuation of health states: a model for estimating cardinal values from ordinal data

PubMed Central

Salomon, Joshua A

2003-01-01

Background In survey studies on health-state valuations, ordinal ranking exercises often are used as precursors to other elicitation methods such as the time trade-off (TTO) or standard gamble, but the ranking data have not been used in deriving cardinal valuations. This study reconsiders the role of ordinal ranks in valuing health and introduces a new approach to estimate interval-scaled valuations based on aggregate ranking data. Methods Analyses were undertaken on data from a previously published general population survey study in the United Kingdom that included rankings and TTO values for hypothetical states described using the EQ-5D classification system. The EQ-5D includes five domains (mobility, self-care, usual activities, pain/discomfort and anxiety/depression) with three possible levels on each. Rank data were analysed using a random utility model, operationalized through conditional logit regression. In the statistical model, probabilities of observed rankings were related to the latent utilities of different health states, modeled as a linear function of EQ-5D domain scores, as in previously reported EQ-5D valuation functions. Predicted valuations based on the conditional logit model were compared to observed TTO values for the 42 states in the study and to predictions based on a model estimated directly from the TTO values. Models were evaluated using the intraclass correlation coefficient (ICC) between predictions and mean observations, and the root mean squared error of predictions at the individual level. Results Agreement between predicted valuations from the rank model and observed TTO values was very high, with an ICC of 0.97, only marginally lower than for predictions based on the model estimated directly from TTO values (ICC = 0.99). Individual-level errors were also comparable in the two models, with root mean squared errors of 0.503 and 0.496 for the rank-based and TTO-based predictions, respectively. Conclusions Modeling health-state valuations based on ordinal ranks can provide results that are similar to those obtained from more widely analyzed valuation techniques such as the TTO. The information content in aggregate ranking data is not currently exploited to full advantage. The possibility of estimating cardinal valuations from ordinal ranks could also simplify future data collection dramatically and facilitate wider empirical study of health-state valuations in diverse settings and population groups. PMID:14687419

Dietary salt restriction is beneficial to the management of autosomal dominant polycystic kidney disease.

PubMed

Torres, Vicente E; Abebe, Kaleab Z; Schrier, Robert W; Perrone, Ronald D; Chapman, Arlene B; Yu, Alan S; Braun, William E; Steinman, Theodore I; Brosnahan, Godela; Hogan, Marie C; Rahbari, Frederic F; Grantham, Jared J; Bae, Kyongtae T; Moore, Charity G; Flessner, Michael F

2017-02-01

The CRISP study of polycystic kidney disease (PKD) found that urinary sodium excretion associated with the rate of total kidney volume increase. Whether sodium restriction slows the progression of Autosomal Dominant PKD (ADPKD) is not known. To evaluate this we conducted a post hoc analysis of the HALT-PKD clinical trials of renin-angiotensin blockade in patients with ADPKD. Linear mixed models examined whether dietary sodium affected rates of total kidney volume or change in estimated glomerular filtration rate (eGFR) in patients with an eGFR over 60 ml/min/1.73 m 2 (Study A) or the risk for a composite endpoint of 50% reduction in eGFR, end-stage renal disease or death, or the rate of eGFR decline in patients with an eGFR 25-60 ml/min/1.73 m 2 (Study B) all in patients initiated on an under100 mEq sodium diet. During the trial urinary sodium excretion significantly declined by an average of 0.25 and 0.41 mEq/24 hour per month in studies A and B, respectively. In Study A, averaged and time varying urinary sodium excretions were significantly associated with kidney growth (0.43%/year and 0.09%/year, respectively, for each 18 mEq urinary sodium excretion). Averaged urinary sodium excretion was not significantly associated with faster eGFR decline (-0.07 ml/min/1.73m 2 /year for each 18 mEq urinary sodium excretion). In Study B, the averaged but not time-varying urinary sodium excretion significantly associated with increased risk for the composite endpoint (hazard ratio 1.08 for each 18 mEq urinary sodium excretion) and a significantly faster eGFR decline (-0.09 ml/min/1.73m 2 /year for each mEq 18 mEq urinary sodium excretion). Thus, sodium restriction is beneficial in the management of ADPKD. Copyright © 2016 International Society of Nephrology. All rights reserved.

Dutch Tariff for the Five-Level Version of EQ-5D.

PubMed

M Versteegh, Matthijs; M Vermeulen, Karin; M A A Evers, Silvia; de Wit, G Ardine; Prenger, Rilana; A Stolk, Elly

2016-06-01

In 2009, a new version of the EuroQol five-dimensional questionnaire (EQ-5D) was introduced with five rather than three answer levels per dimension. This instrument is known as the EQ-5D-5L. To make the EQ-5D-5L suitable for use in economic evaluations, societal values need to be attached to all 3125 health states. To derive a Dutch tariff for the EQ-5D-5L. Health state values were elicited during face-to-face interviews in a general population sample stratified for age, sex, and education, using composite time trade-off (cTTO) and a discrete choice experiment (DCE). Data were modeled using ordinary least squares and tobit regression (for cTTO) and a multinomial conditional logit model (for DCE). Model performance was evaluated on the basis of internal consistency, parsimony, goodness of fit, handling of left-censored values, and theoretical considerations. A representative sample (N = 1003) of the Dutch population participated in the valuation study. Data of 979 and 992 respondents were included in the analysis of the cTTO and the DCE, respectively. The cTTO data were left-censored at -1. The tobit model was considered the preferred model for the tariff on the basis of its handling of the censored nature of the data, which was confirmed through comparison with the DCE data. The predicted values for the EQ-5D-5L ranged from -0.446 to 1. This study established a Dutch tariff for the EQ-5D-5L on the basis of cTTO. The values represent the preferences of the Dutch population. The tariff can be used to estimate the impact of health care interventions on quality of life, for example, in context of economic evaluations. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Developing capacities in aging studies in the Middle East: Implementation of an Arabic version of the CANE IV among community-dwelling older adults in Lebanon.

PubMed

AbiHabib, Laurie E; Chemaitelly, Hiam S; Jaalouk, Lina Y; Karam, Nadim E

2011-07-01

To assess the feasibility, reliability, and construct validity of the Camberwell Assessment of Need for the Elderly (CANE) in identifying needs among community-dwelling older adults in South Lebanon with a view towards expanding ageing research in the country. A cross-sectional study was undertaken with 322 individuals, using the CANE, the EQ5d and a socio-demographic questionnaire. Reliability was determined through measuring internal consistency of the CANE. Construct validity was performed through examining CANE inter-item correlations, and comparing correlations with the EQ5d and socio-demographic indicators. A factor analysis was conducted using varimax orthogonal rotation. Cronbach alpha was 0.71. For construct validity, correlations were highest in items measuring needs in looking after the house and food (r = 0.557); company and intimate relationships (r = 0.572); and medication and written/verbal information (r = 0.586). Moderate correlations were found with EQ5d items assessing the same measure, including: EQ5d 'problems taking care of self' and CANE self-care (r = 0.578) and daytime activities (r = 0.523); EQ5d 'problems performing usual activities' and CANE daytime activities (r = 0.553), self-care (r = 0.511) and mobility (r = 0.500); and EQ5d 'problems while walking' and CANE mobility/falls (r = 0.509). Corresponding items of the CANE and EQ-5d were significantly correlated with similar socio-demographic variables. The factor analysis supported results obtained in the CANE inter-item correlations. The Arabic version of the CANE appears acceptable in assessing needs of older adults in South Lebanon. Given that the CANE is an interesting tool that promotes the integration of older persons' perspectives for appropriate interventions, further research is recommended to establish its validity and applicability in other communities in Lebanon and the region.

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.

Can the anxiety domain of EQ-5D and mental health items from SF-36 help predict outcomes after surgery for lumbar degenerative disorders?

PubMed

Carreon, Leah Y; Djurasovic, Mladen; Dimar, John R; Owens, R Kirk; Crawford, Charles H; Puno, Rolando M; Bratcher, Kelly R; McGraw, Katlyn E; Glassman, Steven D

2016-09-01

OBJECTIVE Studies have shown that anxious or depressed patients may have poorer outcomes after lumbar fusion. These conclusions were drawn from questionnaires specifically designed to measure anxiety and depression. The objective of this study is to determine if responses to the EQ-5D anxiety/depression domain or the items used to calculate the 36-Item Short-Form Health Survey (SF-36) Mental Component Summary (MCS) can predict outcomes after lumbar fusion surgery. METHODS Patients enrolled in the National Neurosurgery Quality and Outcomes Database from a single center with 1-year follow-up were identified. The outcomes collected include the Oswestry Disability Index (ODI), EQ-5D, SF-36, and the back- and leg-pain numeric rating scales (range 0-10). Linear regression modeling was performed to predict the 1-year ODI scores using the EQ-5D anxiety/depression domain and the 14 items used to calculate SF-36 MCS. RESULTS Complete data were available for 312 (88%) of 353 eligible patients. The mean patient age was 58.5 years, 175 (56%) patients were women, and 52 patients were smokers. After controlling for other factors, the item in the SF-36 that asks "Have you felt downhearted and depressed?" is the strongest predictor of the 1-year ODI score (r(2) = 0.191; p = 0.000) and 1-year EQ-5D score (r(2) = 0.205; p = 0.000). Neither the EQ-5D anxiety/depression domain nor the diagnoses of anxiety or depression were predictors of 1-year outcomes. CONCLUSIONS Patient responses to SF-36 item "Have you felt downhearted and depressed?" account for 20% of the variability of the 1-year ODI and EQ-5D scores and can be used by clinicians to screen for anxiety or depression in patients prior to lumbar fusion surgery. Clinicians may offer psychological support to these patients preoperatively in order to improve treatment outcomes.

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.

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 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

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.

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.

Synthesis of [Fe(Leq)(Lax)] n coordination polymer nanoparticles using blockcopolymer micelles.

PubMed

Göbel, Christoph; Klimm, Ottokar; Puchtler, Florian; Rosenfeldt, Sabine; Förster, Stephan; Weber, Birgit

2017-01-01

Spin-crossover compounds are a class of materials that can change their spin state from high spin (HS) to low spin (LS) by external stimuli such as light, pressure or temperature. Applications demand compounds with defined properties concerning the size and switchability that are maintained when the compound is integrated into composite materials. Here, we report the synthesis of [Fe(L eq )(L ax )] n coordination polymer (CP) nanoparticles using self-assembled polystyrene- block -poly(4-vinylpyridine) (PS- b -P4VP) block copolymer (BCP) micelles as template. Variation of the solvent (THF and toluene) and the rigidity of the axial ligand L ax (L ax = 1,2-di(pyridin-4-yl)ethane) (bpea), trans -1,2-di(pyridin-4-yl)ethene (bpee), and 1,2-di(pyridin-4-yl)ethyne) (bpey); L eq = 1,2-phenylenebis(iminomethylidyne)-bis(2,4-pentanedionato)(2-)) allowed the determination of the preconditions for the selective formation of nanoparticles. A low solubility of the CP in the used solvent and a high stability of the Fe-L bond with regard to ligand exchange are necessary for the formation of composite nanoparticles where the BCP micelle is filled with the CP, as in the case of the [FeL eq (bpey)] n @BCP. Otherwise, in the case of more flexible ligands or ligands that lead to high spin complexes, the formation of microcrystals next to the CP-BCP nanoparticles is observed above a certain concentration of [Fe(L eq )(L ax )] n . The core of the nanoparticles is about 45 nm in diameter due to the templating effect of the BCP micelle, independent of the used iron complex and [Fe(L eq )(L ax )] n concentration. The spin-crossover properties of the composite material are similar to those of the bulk for FeL eq (bpea)] n @BCP while pronounced differences are observed in the case of [FeL eq (bpey)] n @BCP nanoparticles.

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)

Omega-Omega interaction from 2+1-flavor lattice quantum chromodynamics

NASA Astrophysics Data System (ADS)

Yamada, Masanori; Sasaki, Kenji; Aoki, Sinya; Doi, Takumi; Hatsuda, Tetsuo; Ikeda, Yoichi; Inoue, Takashi; Ishii, Noriyoshi; Murano, Keiko; Nemura, Hidekatsu

2015-07-01

We investigate the interaction between Ω baryons in the {^{1}S}_0 channel from 2{+ }1-flavor lattice quantum chromodynamics (QCD) simulations. On the basis of the HAL QCD method, the Ω Ω potential is extracted from the Nambu-Bethe-Salpeter wave function calculated on the lattice by using the PACS-CS gauge configurations with a lattice spacing of a˜eq 0.09fm, a lattice volume of L˜eq 2.9fm, and quark masses corresponding to m_π ˜eq 700MeV and m_Ω ˜eq 1970MeV. The Ω Ω potential has a repulsive core at short distances and an attractive well at intermediate distances. Accordingly, the phase shift obtained from the potential shows moderate attraction at low energies. Our data indicate that the Ω Ω system with the present quark masses may appear close to the unitary limit where the scattering length diverges.

\\varvec{B^0→ K^{*0}μ ^+μ ^-} decay in the aligned two-Higgs-doublet model

NASA Astrophysics Data System (ADS)

Hu, Quan-Yi; Li, Xin-Qiang; Yang, Ya-Dong

2017-03-01

In the aligned two-Higgs-doublet model, we perform a complete one-loop computation of the short-distance Wilson coefficients C_{7,9,10}^{(' )}, which are the most relevant ones for b→ sℓ ^+ℓ ^- transitions. It is found that, when the model parameter | σ u| is much smaller than | σd| , the charged scalar contributes mainly to chirality-flipped C_{9,10}^' , with the corresponding effects being proportional to | σd| ^2. Numerically, the charged-scalar effects fit into two categories: (A) C_{7,9,10}^{H^± } are sizable, but C_{9,10}^' {H^± }}˜eq 0, corresponding to the (large | σu| , small | σd| ) region; (B) C_7^{H^± } and C_{9,10}^' {H^± }} are sizable, but C_{9,10}^{H^± }˜eq 0, corresponding to the (small | σu| , large | σd| ) region. Taking into account phenomenological constraints from the inclusive radiative decay B→ Xs{γ }, as well as the latest model-independent global analysis of b→ sℓ ^+ℓ ^- data, we obtain the much restricted parameter space of the model. We then study the impact of the allowed model parameters on the angular observables P_2 and P_5' of B^0→ K^{*0}μ ^+μ ^- decay, and we find that P_5' could be increased significantly to be consistent with the experimental data in case B.

Comparison of carbon footprints of steel versus concrete pipelines for water transmission.

PubMed

Chilana, Lalit; Bhatt, Arpita H; Najafi, Mohammad; Sattler, Melanie

2016-05-01

The global demand for water transmission and service pipelines is expected to more than double between 2012 and 2022. This study compared the carbon footprint of the two most common materials used for large-diameter water transmission pipelines, steel pipe (SP) and prestressed concrete cylinder pipe (PCCP). A planned water transmission pipeline in Texas was used as a case study. Four life-cycle phases for each material were considered: material production and pipeline fabrication, pipe transportation to the job site, pipe installation in the trench, and operation of the pipeline. In each phase, the energy consumed and the CO2-equivalent emissions were quantified. It was found that pipe manufacturing consumed a large amount of energy, and thus contributed more than 90% of life cycle carbon emissions for both kinds of pipe. Steel pipe had 64% larger CO2-eq emissions from manufacturing compared to PCCP. For the transportation phase, PCCP consumed more fuel due to its heavy weight, and therefore had larger CO2-eq emissions. Fuel consumption by construction equipment for installation of pipe was found to be similar for steel pipe and PCCP. Overall, steel had a 32% larger footprint due to greater energy used during manufacturing. This study compared the carbon footprint of two large-diameter water transmission pipeline materials, steel and prestressed concrete cylinder, considering four life-cycle phases for each. The study provides information that project managers can incorporate into their decision-making process concerning pipeline materials. It also provides information concerning the most important phases of the pipeline life cycle to target for emission reductions.

The impacts of ;urban-induced heavy rains; on the distribution of deposition fluxes of inorganic acidic substances in the Tokyo metropolitan area in summer

NASA Astrophysics Data System (ADS)

Uchiyama, Ryunosuke; Okochi, Hiroshi; Kamiya, Junichi; Asai, Daisuke; Kaneko, Chiho; Ogata, Hiroko; Katsumi, Naoya

2018-02-01

We analyzed the trends in rainfall amounts and the number of heavy rain events with hourly rainfall amounts over 30 mm at the inland section of the 23-ward Tokyo metropolitan area (nine wards and ten sites) in the warm season (July to September) from 1978 to 2008. Heavy rain events in the Nerima Ward occurred nine times during decade I (1978-1987; 0.90 times/yr), 13 times during decade II (1988-1997; 1.3 times/yr), and 23 times during decade III (1998-2008; 2.1 times/yr). The annual average number of heavy rain events was 1.43 times/yr in Nerima from 1978 to 2008, while it was 0.98 times/yr on average at nine locations excluding Nerima. The frequency of extremely strong heavy rain events with hourly rainfall amounts greater than 50 mm during decade III was the highest in Nerima (six times) among ten sites. These data suggest that the frequency of heavy rain events has increased at Nerima during the past 30 years. Bulk precipitation data were collected biweekly by filtration-type collectors at 14 sites around Nerima from 2008 to 2010 to determine the impacts of urban-induced heavy rains (hereafter UHR), defined as a heavy rain event other than typhoons and frontal heavy rains, on the distribution of deposition fluxes of inorganic acidic substances. The NO3- and nss-SO42 - concentrations in bulk precipitation were higher during the periods including UHR than those not including UHR. The deposition fluxes of NO3- and SO42 - showed clear differences at the center of UHR (NO3-: 231 μeq/m2/d, SO42 -: 234 μeq/m2/d) and its surrounding area (NO3-: 76.4 μeq/m2/d, SO42 -: 86.1 μeq/m2/d). Our results suggest that large amounts of inorganic acidic substances are deposited locally by UHR in urban areas in summer.

Environmental impact of heavy pig production in a sample of Italian farms. A cradle to farm-gate analysis.

PubMed

Pirlo, G; Carè, S; Casa, G Della; Marchetti, R; Ponzoni, G; Faeti, V; Fantin, V; Masoni, P; Buttol, P; Zerbinatti, L; Falconi, F

2016-09-15

Four breeding piggeries and eight growing-fattening piggeries were analyzed to estimate potential environmental impacts of heavy pig production (>160kg of live height at slaughtering). Life Cycle Assessment methodology was adopted in the study, considering a system from breeding phase to growing fattening phase. Environmental impacts of breeding phase and growing-fattening phase were accounted separately and then combined to obtain the impacts of heavy pig production. The functional unit was 1kg of live weight gain. Impact categories investigated were global warming (GW), acidification (AC), eutrophication (EU), abiotic depletion (AD), and photochemical ozone formation (PO). The total environmental impact of 1kg of live weight gain was 3.3kg CO2eq, 4.9E-2kg SO2eq, 3.1E-2kg PO4(3-)eq, 3.7E-3kg Sbeq, 1.7E-3kg C2H4eq for GW, AC, EU, AD, and PO respectively. Feed production was the main hotspot in all impact categories. Greenhouse gases responsible for GW were mainly CH4, N2O, and CO2. Ammonia was the most important source of AC, sharing about 90%. Nitrate and NH3 were the main emissions responsible for EU, whereas P and NOx showed minor contributions. Crude oil and natural gas consumption was the main source of AD. A large spectrum of pollutants had a significant impact on PO: they comprised CH4 from manure fermentation, CO2 caused by fossil fuel combustion in agricultural operations and industrial processes, ethane and propene emitted during oil extraction and refining, and hexane used in soybean oil extraction. The farm characteristics that best explained the results were fundamentally connected with performance indicators Farms showed a wide variability of results, meaning that there was wide margin for improving the environmental performance of either breeding or growing-fattening farms. The effectiveness of some mitigation measures was evaluated and the results that could be obtained by their introduction have been presented. Copyright © 2016 Elsevier B.V. All rights reserved.

Magnetospheric electron density long-term (>1 day) refilling rates inferred from passive radio emissions measured by IMAGE RPI during geomagnetically quiet times

NASA Astrophysics Data System (ADS)

Denton, R. E.; Wang, Y.; Webb, P. A.; Tengdin, P. M.; Goldstein, J.; Redfern, J. A.; Reinisch, B. W.

2012-03-01

Using measurements of the electron density ne found from passive radio wave observations by the IMAGE spacecraft RPI instrument on consecutive passes through the magnetosphere, we calculate the long-term (>1 day) refilling rate of equatorial electron density dne,eq/dt from L = 2 to 9. Our events did not exhibit saturation, probably because our data set did not include a deep solar minimum and because saturation is an unusual occurrence, especially outside of solar minimum. The median rate in cm-3/day can be modeled with log10(dne,eq/dt) = 2.22 - 0.006L - 0.0347L2, while the third quartile rate can be modeled with log10(dne,eq/dt) = 3.39 - 0.353L, and the mean rate can be modeled as log10(dne,eq/dt) = 2.74 - 0.269L. These statistical values are found from the ensemble of all observed rates at each L value, including negative rates (decreases in density due to azimuthal structure or radial motion or for other reasons), in order to characterize the typical behavior. The first quartile rates are usually negative for L < 4.7 and close to zero for larger L values. Our rates are roughly consistent with previous observations of ion refilling at geostationary orbit. Most previous studies of refilling found larger refilling rates, but many of these examined a single event which may have exhibited unusually rapid refilling. Comparing refilling rates at solar maximum to those at solar minimum, we found that the refilling rate is larger at solar maximum for small L < 4, about the same at solar maximum and solar minimum for L = 4.2 to 5.8, and is larger at solar minimum for large L > 5.8 such as at geostationary orbit (L ˜ 6.8) (at least to L of about 8). These results agree with previous results for ion refilling at geostationary orbit, may agree with previous results at lower L, and are consistent with some trends for ionospheric density.

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.

The English and Chinese versions of the five-level EuroQoL Group's five-dimension questionnaire (EQ-5D) were valid and reliable and provided comparable scores in Asian breast cancer patients.

PubMed

Lee, Chun Fan; Ng, Raymond; Luo, Nan; Wong, Nan Soon; Yap, Yoon Sim; Lo, Soo Kien; Chia, Whay Kuang; Yee, Alethea; Krishna, Lalit; Wong, Celest; Goh, Cynthia; Cheung, Yin Bun

2013-01-01

To examine the measurement properties of and comparability between the English and Chinese versions of the five-level EuroQoL Group's five-dimension questionnaire (EQ-5D) in breast cancer patients in Singapore. This is an observational study of 269 patients. Known-group validity and responsiveness of the EQ-5D utility index and visual analog scale (VAS) were assessed in relation to various clinical characteristics and longitudinal change in performance status, respectively. Convergent and divergent validity was examined by correlation coefficients between the EQ-5D and a breast cancer-specific instrument. Test-retest reliability was evaluated. The two language versions were compared by multiple regression analyses. For both English and Chinese versions, the EQ-5D utility index and VAS demonstrated known-group validity and convergent and divergent validity, and presented sufficient test-retest reliability (intraclass correlation = 0.72 to 0.83). The English version was responsive to changes in performance status. The Chinese version was responsive to decline in performance status, but there was no conclusive evidence about its responsiveness to improvement in performance status. In the comparison analyses of the utility index and VAS between the two language versions, borderline results were obtained, and equivalence cannot be definitely confirmed. The five-level EQ-5D is valid, responsive, and reliable in assessing health outcome of breast cancer patients. The English and Chinese versions provide comparable measurement results.

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.

Ultrasonically assisted antioxidant extraction from grape stalks and olive leaves

NASA Astrophysics Data System (ADS)

Cárcel, Juan A.; García-Pérez, José V.; Mulet, Antonio; Rodríguez, Ligia; Riera, Enrique

2010-01-01

Grape stalks and olive leaves present high amount of phenolic compounds with antioxidant properties. The extraction of these compounds may be considered a way to increase in value both agro-food by-products. Ultrasound is widely applied in extraction due to its effects (cavitation, microstirring or sponge effect) over the process. The goal of this work was to address the application of ultrasound on the antioxidant extraction of olive leaves and grape stalk. For that purpose, the extraction of antioxidant compounds from grape stalks and olive leaves, previously dried at 100 °C, were carried out using a ethanolic solution (80 % v/v) at 60 °C. Extractions were carried out with (US; 30 kHz; 600W)) and agitation (AG) without ultrasound application. In the AG experiments, the solution was agitated with a stirrer. Samples were obtained at different extraction time (10, 30, 60, 120, 180, 240, 360, 480 and 1440 min) and their antioxidant capacity was measured using FRAP method. The Naik model was used to model the extraction kinetics, being identified the antioxidant capacity of extracts at the equilibrium (Y eq) and the initial velocity of extraction (Y eq/B). For grape stalks, the antioxidant capacity of extracts at the equilibrium (Y eq) and the initial velocity of extraction (Y eq/B) were higher in AG experiments than in US experiments. In the olive leaves extractions, the Y eq/B was of the same order for both treatments but Y eq was significantly higher for US experiments. The different influence of ultrasound for both by-products can be explained from their different geometry and structure.

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

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.

Simulation of the transient indiffusion-segregation process of triply negatively charged Ga vacancies in GaAs and AlAs/GaAs superlattices

NASA Astrophysics Data System (ADS)

You, Horng-Ming; Gösele, Ulrich M.; Tan, Teh Y.

1993-08-01

In GaAs and AlAs/GaAs superlattice crystals containing n-type regions, several sets of recent experimental results obtained from diffusion studies require the interpretation that the responsible point defect species, the triply negatively charged Ga vacancy (VGa3-), has attained its thermal equilibrium concentration (CVGa3-eq) at the onset of an experiment. This could be due to either the fact that under heavy n-doping conditions CVGa3-eq is fairly temperature independent, or the fact that the transient process of populating VGa3- from an undersaturated to the appropriate CVGa3-eq value via indiffusion from the surfaces to the interior of the crystals is extremely rapid. We have simulated the transient process of populating VGa3- to the crystal interior. The experiments use crystals consisting of adjacent intrinsic and n-type regions for which CVGa3-eq values are different, leading to the simultaneous occurrence of VGa3- diffusion and segregation phenomena. A diffusion-segregation equation has been derived and subsequently used in the simulation calculations. The simulation results showed that, as long as n-type regions are involved, such transient processes are ineffective and therefore cannot explain the experimental requirement that VGa3- is already present in the appropriate CVGa3-eq(n) value at the onset of an experiment. On the other hand, the transient process is sufficiently rapid for the purely intrinsic crystal cases. These simulation results support our recent finding that the CVGa3-eq(n) values are essentially temperature independent, obtained via a thermodynamic treatment.

The correlation between brain gray matter volume and empathizing and systemizing quotients in healthy children.

PubMed

Sassa, Yuko; Taki, Yasuyuki; Takeuchi, Hikaru; Hashizume, Hiroshi; Asano, Michiko; Asano, Kohei; Wakabayashi, Akio; Kawashima, Ryuta

2012-05-01

The abilities to empathize and to systemize, two fundamental dimensions of cognitive style, are characterized by apparent individual differences. These abilities are typically measured using an empathizing quotient (EQ) and a systemizing quotient (SQ) questionnaire, respectively. The purpose of this study was to reveal any correlations between EQ and SQ scores and regional gray matter volumes in healthy children by applying voxel-based morphometry to magnetic resonance images. We collected MRIs of brain structure and administered children's versions of the EQ and SQ questionnaires (EQ-C and SQ-C, respectively) to 261 healthy children aged 5-15 years. Structural MRI data were segmented, normalized, and smoothed using an optimized voxel-based morphometric analysis. Next, we analyzed the correlation between regional gray matter volume and EQ-C and SQ-C scores adjusting for age, sex, and intracranial volume. The EQ-C scores showed significant positive correlations with the regional gray matter volumes of the left fronto-opercular and superior temporal cortices, including the precentral gyrus, the inferior frontal gyrus, the superior temporal gyrus, and the insula, which are functionally related to empathic processing. Additionally, SQ-C scores showed a significant negative correlation with the regional gray matter volume of the left posterior parietal cortex, which is functionally involved in selective attention processing. Our findings suggest that individual differences in cognitive style pertaining to empathizing or systemizing abilities could be explained by differences in the volume of brain structures that are functionally relevant to empathizing and systemizing. Copyright © 2012 Elsevier Inc. All rights reserved.

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.

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).

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.

Change in health status (EQ-5D) over 5 years among individuals with and without type 2 diabetes mellitus in the SHIELD longitudinal study.

PubMed

Grandy, Susan; Fox, Kathleen M

2012-08-21

Health-related quality of life studies among adults with type 2 diabetes mellitus, using the EQ-5D, have been short term and have not assessed change over years. This study assessed the change in health status and health-related quality of life over 5 years among individuals with and without diabetes. Respondents to the US Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD) completed the EuroQol-5D (EQ-5D) at baseline (2004) and 5 years later (2009). Visual analog scale (VAS) score and health index score were computed at baseline and year 5, and the change over 5 years was measured for individuals with type 2 diabetes mellitus (T2DM) and those without diabetes, and T2DM adults with and without diabetic complications. Linear regression models were used to determine change in EQ-5D score, controlling for age, gender, race, education, household income, and body mass index (BMI). There was significantly greater decline in the EQ-5D index score in the T2DM group (-0.031 [SD 0.158]), compared with those without diabetes (-0.016 [0.141], p = 0.001). Compared with respondents without diabetes, those with T2DM had a larger reduction in EQ-5D index score, after controlling for demographics (p = 0.001). EQ-5D VAS score declined over 5 years for both groups: -1.42 (18.1) for the T2DM group, and -0.63 (15.8) for the group without diabetes, but the between-group difference was not significant either before (p = 0.09) or after (p = 0.12), controlling for demographics. T2DM respondents with diabetic complications had a greater decline in EQ-5D scores than T2DM respondents without complications (p < 0.05). Over a 5-year period, health status of respondents with T2DM declined significantly compared with those with no diabetes, indicating that the burden of the disease has a long-term detrimental impact. This decline in health status is likely to impact utility scores (fewer quality-adjusted life years) for economic evaluations.

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.

A landscape-based reconnaissance survey of estrogenic activity in streams of the upper Potomac, upper James, and Shenandoah Rivers, USA.

PubMed

Young, John; Iwanowicz, Luke; Sperry, Adam; Blazer, Vicki

2014-09-01

Endocrine-disrupting compounds (EDCs) are becoming of increasing concern in waterways of the USA and worldwide. What remains poorly understood, however, is how prevalent these emerging contaminants are in the environment and what methods are best able to determine landscape sources of EDCs. We describe the development of a spatially structured sampling design and a reconnaissance survey of estrogenic activity along gradients of land use within sub-watersheds. We present this example as a useful approach for state and federal agencies with an interest in identifying locations potentially impacted by EDCs that warrant more intensive, focused research. Our study confirms the importance of agricultural activities on levels of a measured estrogenic equivalent (E2Eq) and also highlights the importance of other potential sources of E2Eq in areas where intensive agriculture is not the dominant land use. Through application of readily available geographic information system (GIS) data, coupled with spatial statistical analysis, we demonstrate the correlation of specific land use types to levels of estrogenic activity across a large area in a consistent and unbiased manner.

A landscape-based reconnaissance survey of estrogenicactivity in streams of the upper Potomac, upper James,and Shenandoah Rivers, USA

USGS Publications Warehouse

Young, John A.; Iwanowicz, Luke R.; Sperry, Adam J.; Blazer, Vicki

2014-01-01

Endocrine-disrupting compounds (EDCs) are becoming of increasing concern in waterways of the USA and worldwide. What remains poorly understood, however, is how prevalent these emerging contaminants are in the environment and what methods are best able to determine landscape sources of EDCs. We describe the development of a spatially structured sampling design and a reconnaissance survey of estrogenic activity along gradients of land use within sub-watersheds.We present this example as a useful approach for state and federal agencies with an interest in identifying locations potentially impacted by EDCs that warrant more intensive, focused research. Our study confirms the importance of agricultural activities on levels of a measured estrogenic equivalent (E2Eq) and also highlights the importance of other potential sources of E2Eq in areas where intensive agriculture is not the dominant land use. Through application of readily available geographic information system (GIS) data, coupled with spatial statistical analysis, we demonstrate the correlation of specific land use types to levels of estrogenic activity across a large area in a consistent and unbiased manner.

Hyponatraemia in cancer patients on an inpatient rehabilitation unit.

PubMed

Nelson, M; Palmer, J L; Fu, J; Williams, J L; Yadav, R; Guo, Y

2014-05-01

This study identifies the incidence of hyponatraemia in cancer patients on an inpatient rehabilitation unit and examines the association between admission hyponatraemia and rehabilitation length of stay (LOS), functional outcome, and survival. After institutional review committee's approval, we retrospectively reviewed medical records of 295 consecutive patients who were admitted to this inpatient cancer rehabilitation unit between 27 January 2009 through 31 July 2010 in a tertiary cancer centre. The incidence of hyponatraemia in cancer patients admitted to our inpatient rehabilitation unit was 41.4%. Median rehabilitation LOS for patients with mild (Na 130-134 mEq/L) and moderate-severe (Na < 130 mEq/L) hyponatraemia was 11 and 15 days, respectively, which was significantly longer than patients with eunatraemia (10 days; P = 0.03). Functional Independence Measure gain for ambulation and transfers during inpatient rehabilitation stay was not significantly different between three different patient groups. We concluded that large portion of patients who require acute inpatient rehabilitation presented with hyponatraemia, which is associated with prolonged rehabilitation LOS. Whether aggressive management of hyponatraemia will shorten rehabilitation stay needs further study. © 2013 John Wiley & Sons Ltd.

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

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

Relationships among cytochromes P450 and dioxin equivalents in pipping heron embryos from Virginia, the Great Lakes and San Francisco Bay

USGS Publications Warehouse

Rattner, B.A.; Hatfield, J.S.; Melancon, M.J.; Custer, T.W.; Tillett, D.E.

1993-01-01

Pipping black-crowned night-heron (Nycticorax nycticorax) embryos were collected from undisturbed (Chincoteague National Wildlife Refuge, VA) and industrialized (Cat Island, Green Bay, WI; San Francisco Bay, CA) locations. Hepatic P450 associated monooxygenases (AHH, EROD, BROD, ECOD) and P450 proteins (CYP1A, CYP2B) were induced up to 85-fold, and were associated with burdens of total PCBs and 11 AHH-active PCB congeners. Dioxin equivalents (TCDD-EQs) of sample extracts, derived by bioassay (H4I1E rat hepatoma cell) and mathematically (product of PCB congener concentration and relative TCDD potency), revealed greatest TCDD-EQs in Cat Island samples. TCDD-EQs were associated with P450s, especially BROD, EROD and CYP1A (r2 = 0.35 to 0.66). TCDD-EQs derived by bioassay were highly correlated with TCDD-EQs derived mathematically (r2 = 0.58 to 0.67) . Multiple regressions were also performed to investigate relationships among P450s and PCB congeners. In summary, these data demonstrate that hepatic P450s of heron embryos are biomarkers of exposure to dioxin-like compounds and provide further evidence that this species has considerable value for assessing wetland and estuarine contamination.

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

A Cross-sectional Assessment of Health-related Quality of Life among Patients with Chronic Obstructive Pulmonary Disease

PubMed Central

GARCIA-GORDILLO, Miguel Ángel; COLLADO-MATEO, Daniel; OLIVARES, Pedro Rufino; ADSUAR, José Carmelo; MERELLANO-NAVARRO, Eugenio

2017-01-01

Background: Chronic obstructive pulmonary disease (COPD) is a major cause of mortality characterized by progressive airflow obstruction and inflammation in the airways, which has an impact on health-related quality of life. The EQ-5D-5L is one of the most used preference-based, health-related quality of life questionnaire. The objective of this study was to provide normative values of EQ-5D-5L for Spanish people suffering from COPD. Methods: Data were extracted from the Spanish National Health Survey (2011/2012). Overall, 1130 people with COPD participated in this survey. The utility index of EQ-5D-5L and the Visual Analog Scale (VAS) score were defined by gender, region, and age. Results: Mean (SD) EQ-5D-5L utility index and VAS score for Spanish people with COPD were 0.742 (0.309) and 60.466 (21.934) respectively. In general, men reported better health status than women. Ceiling effect of the whole sample was 30.35%. Conclusion: The current study provides normative values of EQ-5D-5L for Spanish people affected by COPD. Ceiling effect was high and better results were observed in men compared with women. PMID:28894705

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.

A cross-sectional assessment of health-related quality of life in Chinese patients with chronic hepatitis c virus infection with EQ-5D.

PubMed

Huang, Rui; Rao, Huiying; Shang, Jia; Chen, Hong; Li, Jun; Xie, Qing; Gao, Zhiliang; Wang, Lei; Wei, Jia; Jiang, Jianning; Sun, Jian; Jiang, Jiaji; Wei, Lai

2018-06-15

Hepatitis C virus (HCV) infection is one of the most common liver infections, with a decrement in HRQoL of HCV patients. This study aims to assess Health-related quality of life (HRQoL) in Chinese patients with chronic HCV infection, and to identify significant predictors of the HRQoL in these patients of China. In this cross-sectional observational study, treatment-naïve Han ethnic adults with chronic HCV infection were enrolled. Adopting European Quality of Life scale (EQ-5D) and EuroQOL visual analogue scale (EQ-VAS) were used to qualify HRQoL. Results were reported in descriptive analyses to describe sociodemographic and clinical characteristics. Multiple linear regression analysis was applied to investigate the associations of these variables with HRQoL. Binary logistic regression analysis was performed to identify associations of these variables with HRQoL by dimensions of EQ-5D. Nine hundred ninety-seven patients were enrolled in the study [median age 46.0 (37.0, 56.0) years; male 54.8%]. Mean EQ-5D index and EQ-VAS score were 0.780 ± 0.083 and 77.2 ± 14.8. Multiple Linear regression analysis showed that income (< 2000 RMB, β = - 0.134; 2000-4999 RMB, β = - 0.085), moderate or severe symptoms of discomfort (more than one symptoms, β = - 0.090), disease profile (cirrhosis, β = - 0.114), hyperlipidemia (β = - 0.065) and depression (β = - 0.065) were independently associated with EQ-5D index. Residence (the west, β = 0.087), income (< 2000 RMB, β = - 0.129; 2000-4999 RMB, β = - 0.052), moderate or severe symptoms of discomfort (more than one symptoms, β = - 0.091), disease profile and depression (β = - 0.316) were the influencing factors on EQ-VAS. Binary logistic regression indicated that disease profile and clinical depression were the major influencing factors on all five dimensions of EQ-5D. In this cross-sectional assessment of HCV patients in China, we indicated HRQoL of Chinese HCV patients. Significant negative associations between HRQoL and sociodemographic and clinical factors such as moderate or severe symptoms of discomfort, disease profile and depression emerged. We have to focus on optimally managing care of HCV patients and improving their HRQoL. ClinicalTrials.gov identifier NCT01293279. Date of registration: February 10, 2011.

Surface water acidification responses and critical loads of sulfur and nitrogen deposition in Loch Vale watershed, Colorado

USGS Publications Warehouse

Sullivan, T.J.; Cosby, B.J.; Tonnessen, K.A.; Clow, D.W.

2005-01-01

We evaluated the sensitivity of The Loch, a subalpine lake in Rocky Mountain National Park in Colorado, to acidification in response to increased atmospheric loading of sulfur (S) and nitrogen (N) using the Model of Acidification of Groundwater in Catchments (MAGIC). Lake water acid‐base chemistry was moderately sensitive to changes in both S and N deposition. However, the loads of S deposition that would drive chronic lake water acid neutralizing capacity (ANC) to below 0 or 20 μeq L−1 were estimated to be 11 and 8 kg S ha−1 yr−1, respectively, assuming constant future N deposition at current levels. Comparable loads for N deposition, assuming constant future S deposition, were estimated to be 21 and 12 kg N ha−1 yr−1, respectively. Modeling results for Andrews Creek, an alpine tributary to The Loch, suggested critical loads for surface water acidification that averaged about one third lower. Surface water ANC = 50 μeq L−1 was projected to occur in 50 years in The Loch if S or N deposition increased by a moderate amount (<40%) but could not be achieved in Andrews Creek by reducing either S or N deposition to zero. On the basis of the results of synoptic surveys of lake water chemistry, about one fifth of the wilderness lakes in the Colorado Front Range are more acid‐sensitive than The Loch. This modeling exercise suggests the need for a regional analysis of critical loads for the larger population of acid‐sensitive aquatic resources in order to provide part of the scientific foundation for federally mandated land management decisions.

Estimated HCFC-22 emissions for 1990-2050 in China and the increasing contribution to global emissions

NASA Astrophysics Data System (ADS)

Li, Zhifang; Bie, Pengju; Wang, Ziyuan; Zhang, Zhaoyang; Jiang, Hanyu; Xu, Weiguang; Zhang, Jianbo; Hu, Jianxin

2016-05-01

Chlorodifluoromethane (CHClF2, HCFC-22) is a widely used refrigerant and foaming agent that is not only an ozone-depleting substance (ozone depletion potential (ODP), 0.04) but also a greenhouse gas (global warming potential (GWP), 1780). A comprehensive historical emission inventory for 1990-2014 was produced using a bottom-up method, and a projection through to 2050 was made for China. The results demonstrated that historical emissions increased sharply from 0.2 Gg/yr in 1990 to 127.2 Gg/yr in 2014. Room air-conditioners (RACs), industrial and commercial refrigeration (ICR), and extruded polystyrene (XPS) were three primary emission sources, and accounted for an average of 95.4% of the total emissions over the period studied. The percentage of global HCFC-22 emissions originating from China significantly increased from 0.1% in 1990 to 31.6% in 2012, with an average growth rate of 1.4% per year. Under the Montreal Protocol phasing-out (MPPO) scenario, future emissions were expected to reach a peak of 133.5 Gg/yr in 2016 and then continuously decline to 10.2 Gg/yr in 2050. The accumulative reduction for 2015-2050 would be 5533.8 Gg (equivalent to 221.4 CFC-11-eq Gg and 9850.1 CO2-eq Tg), which is approximately equivalent to the total CO2 emission for China in 2012 (9900 Tg) (Olivier et al., 2013), compared with the no Montreal Protocol scenario (NMP). Under the MPPO scenario, two cases were analyzed to explore the future emission ranges in China. A comparison between the two cases implied that the choice of emission reduction policy will have a considerable impact on HCFC-22 emissions.

Downstream Warming and Headwater Acidity May Diminish Coldwater Habitat in Southern Appalachian Mountain Streams.

PubMed

McDonnell, T C; Sloat, M R; Sullivan, T J; Dolloff, C A; Hessburg, P F; Povak, N A; Jackson, W A; Sams, C

2015-01-01

Stream-dwelling species in the U.S. southern Appalachian Mountains region are particularly vulnerable to climate change and acidification. The objectives of this study were to quantify the spatial extent of contemporary suitable habitat for acid- and thermally sensitive aquatic species and to forecast future habitat loss resulting from expected temperature increases on national forest lands in the southern Appalachian Mountain region. The goal of this study was to help watershed managers identify and assess stream reaches that are potentially vulnerable to warming, acidification, or both. To our knowledge, these results represent the first regional assessment of aquatic habitat suitability with respect to the combined effects of stream water temperature and acid-base status in the United States. Statistical models were developed to predict July mean daily maximum water temperatures and air-water temperature relations to determine potential changes in future stream water temperatures. The length of stream considered suitable habitat for acid- and thermally sensitive species, based on temperature and acid neutralizing capacity thresholds of 20°C and 50 μeq/L, was variable throughout the national forests considered. Stream length displaying temperature above 20°C was generally more than five times greater than the length predicted to have acid neutralizing capacity below 50 μeq/L. It was uncommon for these two stressors to occur within the same stream segment. Results suggested that species' distributional shifts to colder, higher elevation habitats under a warming climate can be constrained by acidification of headwater streams. The approach used in this study can be applied to evaluate climate change impacts to stream water resources in other regions.

Downstream Warming and Headwater Acidity May Diminish Coldwater Habitat in Southern Appalachian Mountain Streams

PubMed Central

Jackson, W. A; Sams, C.

2015-01-01

Stream-dwelling species in the U.S. southern Appalachian Mountains region are particularly vulnerable to climate change and acidification. The objectives of this study were to quantify the spatial extent of contemporary suitable habitat for acid- and thermally sensitive aquatic species and to forecast future habitat loss resulting from expected temperature increases on national forest lands in the southern Appalachian Mountain region. The goal of this study was to help watershed managers identify and assess stream reaches that are potentially vulnerable to warming, acidification, or both. To our knowledge, these results represent the first regional assessment of aquatic habitat suitability with respect to the combined effects of stream water temperature and acid-base status in the United States. Statistical models were developed to predict July mean daily maximum water temperatures and air-water temperature relations to determine potential changes in future stream water temperatures. The length of stream considered suitable habitat for acid- and thermally sensitive species, based on temperature and acid neutralizing capacity thresholds of 20°C and 50 μeq/L, was variable throughout the national forests considered. Stream length displaying temperature above 20°C was generally more than five times greater than the length predicted to have acid neutralizing capacity below 50 μeq/L. It was uncommon for these two stressors to occur within the same stream segment. Results suggested that species’ distributional shifts to colder, higher elevation habitats under a warming climate can be constrained by acidification of headwater streams. The approach used in this study can be applied to evaluate climate change impacts to stream water resources in other regions. PMID:26247361

Consistent quantification of climate impacts due to biogenic carbon storage across a range of bio-product systems

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

Guest, Geoffrey, E-mail: geoffrey.guest@ntnu.no; Bright, Ryan M., E-mail: ryan.m.bright@ntnu.no; Cherubini, Francesco, E-mail: francesco.cherubini@ntnu.no

2013-11-15

Temporary and permanent carbon storage from biogenic sources is seen as a way to mitigate climate change. The aim of this work is to illustrate the need to harmonize the quantification of such mitigation across all possible storage pools in the bio- and anthroposphere. We investigate nine alternative storage cases and a wide array of bio-resource pools: from annual crops, short rotation woody crops, medium rotation temperate forests, and long rotation boreal forests. For each feedstock type and biogenic carbon storage pool, we quantify the carbon cycle climate impact due to the skewed time distribution between emission and sequestration fluxesmore » in the bio- and anthroposphere. Additional consideration of the climate impact from albedo changes in forests is also illustrated for the boreal forest case. When characterizing climate impact with global warming potentials (GWP), we find a large variance in results which is attributed to different combinations of biomass storage and feedstock systems. The storage of biogenic carbon in any storage pool does not always confer climate benefits: even when biogenic carbon is stored long-term in durable product pools, the climate outcome may still be undesirable when the carbon is sourced from slow-growing biomass feedstock. For example, when biogenic carbon from Norway Spruce from Norway is stored in furniture with a mean life time of 43 years, a climate change impact of 0.08 kg CO{sub 2}eq per kg CO{sub 2} stored (100 year time horizon (TH)) would result. It was also found that when biogenic carbon is stored in a pool with negligible leakage to the atmosphere, the resulting GWP factor is not necessarily − 1 CO{sub 2}eq per kg CO{sub 2} stored. As an example, when biogenic CO{sub 2} from Norway Spruce biomass is stored in geological reservoirs with no leakage, we estimate a GWP of − 0.56 kg CO{sub 2}eq per kg CO{sub 2} stored (100 year TH) when albedo effects are also included. The large variance in GWPs across the range of resource and carbon storage options considered indicates that more accurate accounting will require case-specific factors derived following the methodological guidelines provided in this and recent manuscripts. -- Highlights: • Climate impacts of stored biogenic carbon (bio-C) are consistently quantified. • Temporary storage of bio-C does not always equate to a climate cooling impact. • 1 unit of bio-C stored over a time horizon does not always equate to − 1 unit CO{sub 2}eq. • Discrepancies of climate change impact quantification in literature are clarified.« less

High Explosive Simulation of a Nuclear Surface Burst. A Feasibility Study

DTIC Science & Technology

1979-06-30

International Compan ! proposed a method for applying the required close-in airblast loading to the ground surface in conjunction with the MINE THROW...internal energy, e. A check was made to ensure that the above EQS formulation did not introduce large artificial gradients into the pressure. 4.1.3 Some...Proj. Agency Harry Diamond Laboratories ATTN: TIO Department of the Army ATTN: DELHD-N-P Defense Intelligence Agency ATTN: DELHD-I-TL ATTN: DB-4C, E

Aircraft /Stores Compatibility Symposium Proceedings, Held at Arlington, Virginia on 2-4 September 1975. Volume 1

DTIC Science & Technology

1975-09-04

for a large number of candidate fairings would have been too time consuming and the computer time costly for so many runs. This necessitated a paring...factors affect- ing a store’s separation behavior are the forces and moments on the store while in the captive carriage position. Tests have shown that...oscillation started by an initial yaw angle-of-attack would not. The theoretical expression, Eq. (7), confirms this behavior for undamped (T-o.o

Quantal Response: Estimation and Inference

DTIC Science & Technology

2014-09-01

considered. The CI-based test is just another way of looking at the Wald test. A small-sample simulation illustrates aberrant behavior of the Wald/CI...asymptotic power computation (Eq. 36) exhibits this behavior but not to such an extent as the simulated small-sample power. Sample size is n = 11 and...as |m1−m0| increases, but the power of the Wald test actually decreases for large |m1−m0| and eventually π → α . This type of behavior was reported as

On the global limits of bioenergy and land use for climate change mitigation

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

Strapasson, Alexandre; Woods, Jeremy; Chum, Helena

Across energy, agricultural and forestry landscapes, the production of biomass for energy has emerged as a controversial driver of land-use change. We present a novel, simple methodology, to probe the potential global sustainability limits of bioenergy over time for energy provision and climate change mitigation using a complex-systems approach for assessing land-use dynamics. Primary biomass that could provide between 70 EJ year -1 and 360 EJ year -1, globally, by 2050 was simulated in the context of different land-use futures, food diet patterns and climate change mitigation efforts. Our simulations also show ranges of potential greenhouse gas emissions for agriculture,more » forestry and other land uses by 2050, including not only above-ground biomass-related emissions, but also from changes in soil carbon, from as high as 24 GtCO 2eq year-1 to as low as minus 21 GtCO 2eq year -1, which would represent a significant source of negative emissions. Based on the modelling simulations, the discussions offer novel insights about bioenergy as part of a broader integrated system. As a result, there are sustainability limits to the scale of bioenergy provision, they are dynamic over time, being responsive to land management options deployed worldwide.« less

On the global limits of bioenergy and land use for climate change mitigation

DOE PAGES

Strapasson, Alexandre; Woods, Jeremy; Chum, Helena; ...

2017-05-24

Across energy, agricultural and forestry landscapes, the production of biomass for energy has emerged as a controversial driver of land-use change. We present a novel, simple methodology, to probe the potential global sustainability limits of bioenergy over time for energy provision and climate change mitigation using a complex-systems approach for assessing land-use dynamics. Primary biomass that could provide between 70 EJ year -1 and 360 EJ year -1, globally, by 2050 was simulated in the context of different land-use futures, food diet patterns and climate change mitigation efforts. Our simulations also show ranges of potential greenhouse gas emissions for agriculture,more » forestry and other land uses by 2050, including not only above-ground biomass-related emissions, but also from changes in soil carbon, from as high as 24 GtCO 2eq year-1 to as low as minus 21 GtCO 2eq year -1, which would represent a significant source of negative emissions. Based on the modelling simulations, the discussions offer novel insights about bioenergy as part of a broader integrated system. As a result, there are sustainability limits to the scale of bioenergy provision, they are dynamic over time, being responsive to land management options deployed worldwide.« less

Greenhouse gas emissions in the state of Morelos, Mexico: a first approximation for establishing mitigation strategies.

PubMed

Quiroz-Castañeda, Rosa Estela; Sánchez-Salinas, Enrique; Castrejón-Godínez, María Luisa; Ortiz-Hernández, Ma Laura

2013-11-01

In this study, the authors report the first greenhouse gas emission inventory of Morelos, a state in central Mexico, in which the emissions of carbon dioxide (CO2), methane (CH4), and nitrous oxide (N2O) have been identified using the Intergovernmental Panel on Climate Change (IPCC) methodology. Greenhouse gas (GHG) emissions were estimated as CO2 equivalents (CO2 eq) for the years 2005, 2007, and 2009, with 2005 being treated as the base year. The percentage contributions from each category to the CO2 eq emissions in the base year were as follows: 38% from energy, 30% from industrial processes, 23% from waste, 5% from agriculture, and 4% from land use/land use change and forestry (LULUCF). As observed in other state inventories in Mexico, road transportation is the main source of CO2 emissions, wastewater handling and solid waste disposal are the main sources of CH4 emissions, and agricultural soils are the source of the most significant N2O emissions. The information reported in this inventory identifies the main emission sources. Based on these results, the government can propose public policies specifically designed for the state of Morelos to establish GHG mitigation strategies in the near future.

Environmental analysis of a construction and demolition waste recycling plant in Portugal--Part II: Environmental sensitivity analysis.

PubMed

Coelho, André; de Brito, Jorge

2013-01-01

Part I of this study deals with the primary energy consumption and CO(2)eq emissions of a 350 tonnes/h construction and demolition waste (CDW) recycling facility, taking into account incorporated, operation and transportation impacts. It concludes that the generated impacts are mostly concentrated in operation and transportation, and that the impacts prevented through material recycling can be up to one order of magnitude greater than those generated. However, the conditions considered for the plant's operation and related transportation system may, and very likely will, vary in the near future, which will affect its environmental performance. This performance is particularly affected by the plant's installed capacity, transportation fuel and input CDW mass. In spite of the variations in overall primary energy and CO(2)eq balances, the prevented impacts are always higher than the generated impacts, at least by a factor of three and maybe even as high as 16 times in particular conditions. The analysis indicates environmental performance for variations in single parameters, except for the plant's capacity, which was considered to vary simultaneously with all the others. Extreme best and worst scenarios were also generated to fit the results into extreme limits. Copyright © 2012 Elsevier Ltd. All rights reserved.

Current and Future Environmental Balance of Small-Scale Run-of-River Hydropower.

PubMed

Gallagher, John; Styles, David; McNabola, Aonghus; Williams, A Prysor

2015-05-19

Globally, the hydropower (HP) sector has significant potential to increase its capacity by 2050. This study quantifies the energy and resource demands of small-scale HP projects and presents methods to reduce associated environmental impacts based on potential growth in the sector. The environmental burdens of three (50-650 kW) run-of-river HP projects were calculated using life cycle assessment (LCA). The global warming potential (GWP) for the projects to generate electricity ranged from 5.5-8.9 g CO2 eq/kWh, compared with 403 g CO2 eq/kWh for UK marginal grid electricity. A sensitivity analysis accounted for alternative manufacturing processes, transportation, ecodesign considerations, and extended project lifespan. These findings were extrapolated for technically viable HP sites in Europe, with the potential to generate 7.35 TWh and offset over 2.96 Mt of CO2 from grid electricity per annum. Incorporation of ecodesign could provide resource savings for these HP projects: avoiding 800 000 tonnes of concrete, 10 000 tonnes of steel, and 65 million vehicle miles. Small additional material and energy contributions can double a HP system lifespan, providing 39-47% reductions for all environmental impact categories. In a world of finite resources, this paper highlights the importance of HP as a resource-efficient, renewable energy system.

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.

Assessing decentering: validation, psychometric properties, and clinical usefulness of the Experiences Questionnaire in a Spanish sample.

PubMed

Soler, Joaquim; Franquesa, Alba; Feliu-Soler, Albert; Cebolla, Ausias; García-Campayo, Javier; Tejedor, Rosa; Demarzo, Marcelo; Baños, Rosa; Pascual, Juan Carlos; Portella, Maria J

2014-11-01

Decentering is defined as the ability to observe one's thoughts and feelings in a detached manner. The Experiences Questionnaire (EQ) is a self-report instrument that originally assessed decentering and rumination. The purpose of this study was to evaluate the psychometric properties of the Spanish version of EQ-Decentering and to explore its clinical usefulness. The 11-item EQ-Decentering subscale was translated into Spanish and psychometric properties were examined in a sample of 921 adult individuals, 231 with psychiatric disorders and 690 without. The subsample of nonpsychiatric participants was also split according to their previous meditative experience (meditative participants, n=341; and nonmeditative participants, n=349). Additionally, differences among these three subgroups were explored to determine clinical validity of the scale. Finally, EQ-Decentering was administered twice in a group of borderline personality disorder, before and after a 10-week mindfulness intervention. Confirmatory factor analysis indicated acceptable model fit, sbχ(2)=243.8836 (p<.001), CFI=.939, GFI=.936, SRMR=.040, and RMSEA=.06 (.060-.077), and psychometric properties were found to be satisfactory (reliability: Cronbach's α=.893; convergent validity: r>.46; and divergent validity: r<-.35). The scale detected changes in decentering after a 10-session intervention in mindfulness (t=-4.692, p<.00001). Differences among groups were significant (F=134.8, p<.000001), where psychiatric participants showed the lowest scores compared to nonpsychiatric meditative and nonmeditative participants. The Spanish version of the EQ-Decentering is a valid and reliable instrument to assess decentering either in clinical and nonclinical samples. In addition, the findings show that EQ-Decentering seems an adequate outcome instrument to detect changes after mindfulness-based interventions. Copyright © 2014. Published by Elsevier Ltd.

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.

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.

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.

Hepatocyte growth factor acts as a mitogen for equine satellite cells via protein kinase C δ directed signaling.

PubMed

Brandt, Amanda M; Kania, Joanna M; Gonzalez, Madison L; Johnson, Sally E

2018-06-16

Hepatocyte growth factor (HGF) signals mediate mouse skeletal muscle stem cell, or satellite cell (SC), reentry into the cell cycle and myoblast proliferation. Because the athletic horse experiences exercise-induced muscle damage, the objective of the experiment was to determine the effect of HGF on equine SC (eqSC) bioactivity. Fresh isolates of adult eqSC were incubated with increasing concentrations of HGF and the initial time to DNA synthesis was measured. Media supplementation with HGF did not shorten (P > 0.05) the duration of G0/G1 transition suggesting the growth factor does not affect activation. Treatment with 25 ng/mL HGF increased (P < 0.05) eqSC proliferation that was coincident with phosphorylation of extracellular signal-regulated kinase (ERK)1/2 and AKT serine/threonine kinase 1 (AKT1). Chemical inhibition of the upstream effectors of ERK1/2 or AKT1 elicited no effect (P > 0.05) on HGF-mediated EdU incorporation. By contrast, treatment of eqSC with 2 µm Gö6983, a pan-protein kinase C (PKC) inhibitor, blocked (P < 0.05) HGF-initiated mitotic activity. Gene expression analysis revealed that eqSC express PKCα, -δ and -ε isoforms. Knockdown of PKCδ with a small interfering RNA (siRNA) prevented (P > 0.05) HGF-mediated EdU incorporation. The siPKCδ was specific to the kinase and did not affect (P > 0.05) expression of either PKCα or PKCε. Treatment of confluent eqSCs with 25 ng/mL HGF suppressed (P < 0.05) nuclear myogenin expression during the early stages of differentiation. These results demonstrate that HGF may not affect activation but can act as a mitogen and modest suppressor of differentiation.

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.

Contribution to the risk characterization of ciguatoxins: LOAEL estimated from eight ciguatera fish poisoning events in Guadeloupe (French West Indies).

PubMed

Hossen, Virginie; Soliño, Lucia; Leroy, Patricia; David, Eric; Velge, Pierre; Dragacci, Sylviane; Krys, Sophie; Flores Quintana, Harold; Diogène, Jorge

2015-11-01

From 2010 to 2012, 35 ciguatera fish poisoning (CFP) events involving 87 individuals who consumed locally-caught fish were reported in Guadeloupe (French West Indies). For 12 of these events, the presence of ciguatoxins (CTXs) was indicated in meal remnants and in uncooked fish by the mouse bioassay (MBA). Caribbean ciguatoxins (C-CTXs) were confirmed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis. Using a cell-based assay (CBA), and the only available standard Pacific ciguatoxin-1 (P-CTX-1), the lowest toxins level detected in fish samples causing CFP was 0.022 µg P-CTX-1 equivalent (eq.)·kg(-1) fish. Epidemiological and consumption data were compiled for most of the individuals afflicted, and complete data for establishing the lowest observable adverse effects level (LOAEL) were obtained from 8 CFP events involving 21 individuals. Based on toxin intakes, the LOAEL was estimated at 4.2 ng P-CTX-1 eq./individual corresponding to 48. 4 pg P-CTX-1 eq.kg(-1) body weight (bw). Although based on limited data, these results are consistent with the conclusions of the European Food Safety Authority (EFSA) opinion which indicates that a level of 0.01 µg P-CTX-1 eq.kg(-1) fish, regardless of source, should not exert effects in sensitive individuals when consuming a single meal. The calculated LOAEL is also consistent with the U.S. Food and Drug Administration guidance levels for CTXs (0.1 µg C-CTX-1 eq.kg(-1) and 0.01 µg P-CTX-1 eq.kg(-1) fish). Copyright © 2015 Elsevier Inc. All rights reserved.

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

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.

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.

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.

Greenhouse gas emissions of different waste treatment options for sector-specific commercial and industrial waste in Germany.

PubMed

Helftewes, Markus; Flamme, Sabine; Nelles, Michael

2012-04-01

This article investigates greenhouse gas (GHG) emissions from commercial and industrial (C&I) waste treatment considering five sector-specific waste compositions and four different treatment scenarios in Germany. Results show that the highest share of CO₂-equivalent emissions can be avoided in each of the analysed industrial sectors if solid recovered fuel (SRF) is produced for co-incineration in cement kilns. Across all industries, emissions of approximately 680 kg CO₂-eq. Mg⁻¹ C&I waste can be avoided on average under this scenario. The combustion of C&I waste in waste incineration plants without any previous mechanical treatment generates the lowest potential to avoid GHG emissions with a value of approximately 50 kg CO₂-eq. Mg⁻¹ C&I waste on average in all industries. If recyclables are sorted, this can save emissions of approximately 280 kg CO₂-eq. Mg⁻¹ C&I waste while the treatment in SRF power plants amounts to savings of approximately 210 kg CO₂-eq. Mg⁻¹ C&I waste. A comparison of the treatment scenarios of the waste from these five sectors shows that waste treatment of the craft sector leads to the lowest CO₂-equivalent reduction rates of all scenarios. In contrast, the treatment of waste from catering sector leads to the highest CO₂-equivalent reduction rates except for direct incineration in waste incineration plants. The sensitivity analysis of the different scenarios for this paper shows that the efficiency and the substitution factor of energy have a relevant influence on the result. Changes in the substitution factor of 10% can result in changes in emissions of approximately 55 to 75 kg CO₂-eq. Mg⁻¹ in waste incineration plants and approximately 90 kg CO₂-eq. Mg⁻¹ in the case of cement kilns.

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.

Determinants of time trade-off valuations for EQ-5D-5L health states: data from the Canadian EQ-5D-5L valuation study.

PubMed

Sayah, Fatima Al; Bansback, Nick; Bryan, Stirling; Ohinmaa, Arto; Poissant, Lise; Pullenayegum, Eleanor; Xie, Feng; Johnson, Jeffrey A

2016-07-01

Previous studies suggest that population subgroups have different perceptions of health, as well as different preferences for hypothetical health states. To identify determinants of health states preferences elicited using time trade-off (TTO) for the 5-level EQ-5D questionnaire (EQ-5D-5L) in Canada. Data were from the Canadian EQ-5D-5L Valuation Study, which took place in Edmonton, Hamilton, Montreal, and Vancouver. Each respondent valued 10 of 86 hypothetical health states during an in-person interview using a computer-based TTO exercise. The TTO scores were the dependent variable and explanatory variables including age, sex, marital status, education, employment, annual household income, ethnicity, country of birth, dwelling, study site, health literacy, number of chronic conditions, previous experience with illness, and self-rated health. Average [standard deviation (SD)] age of respondents (N = 1209) was 48 (17) years, and 45 % were male. In multivariable linear regression models with random effects, adjusted for severity of health states and inconsistencies in valuations, older age [unstandardized regression coefficient (β) = -0.077], male sex (β = 0.042), being married (β = 0.069), and urban dwelling (β = -0.055) were significantly associated with health states scores. Additionally, participants from Edmonton (β = -0.124) and Vancouver (β = -0.156), but not those from Hamilton, had significantly lower TTO scores than those from Montreal. Socio-demographic characteristics were the main determinants of preferences for EQ-5D-5L health states in this study. Interestingly, preferences were significantly lower in western Canadian cities compared to eastern ones, bringing into question whether a single preference algorithm is suitable for use in all parts of Canada.

Consequential environmental and economic life cycle assessment of green and gray stormwater infrastructures for combined sewer systems.

PubMed

Wang, Ranran; Eckelman, Matthew J; Zimmerman, Julie B

2013-10-01

A consequential life cycle assessment (LCA) is conducted to evaluate the trade-offs between water quality improvements and the incremental climate, resource, and economic costs of implementing green (bioretention basin, green roof, and permeable pavement) versus gray (municipal separate stormwater sewer systems, MS4) alternatives of stormwater infrastructure expansions against a baseline combined sewer system with combined sewer overflows in a typical Northeast US watershed for typical, dry, and wet years. Results show that bioretention basins can achieve water quality improvement goals (e.g., mitigating freshwater eutrophication) for the least climate and economic costs of 61 kg CO2 eq. and $98 per kg P eq. reduction, respectively. MS4 demonstrates the minimum life cycle fossil energy use of 42 kg oil eq. per kg P eq. reduction. When integrated with the expansion in stormwater infrastructure, implementation of advanced wastewater treatment processes can further reduce the impact of stormwater runoff on aquatic environment at a minimal environmental cost (77 kg CO2 eq. per kg P eq. reduction), which provides support and valuable insights for the further development of integrated management of stormwater and wastewater. The consideration of critical model parameters (i.e., precipitation intensity, land imperviousness, and infrastructure life expectancy) highlighted the importance and implications of varying local conditions and infrastructure characteristics on the costs and benefits of stormwater management. Of particular note is that the impact of MS4 on the local aquatic environment is highly dependent on local runoff quality indicating that a combined system of green infrastructure prior to MS4 potentially provides a more cost-effective improvement to local water quality.

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.

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

Hypernatremic Dehydration in Young Children: Is There a Solution?

PubMed

Ben-Shalom, Efrat; Toker, Ori; Schwartz, Shepard

2016-02-01

Hypernatremic dehydration is a common and potentially life-threatening condition in children. There is currently no consensus as to the optimal strategy for fluid management. To describe the relationship between the type, route and rate of fluids administered and the rate of decline in serum sodium (Na+) concentration. We reviewed the medical records of all children under the age of 2 years who were hospitalized with hypernatremic dehydration (serum Na+ ≥ 155 mEq/L) in Shaare Zedek Medical Center during the period 2001-2010. Collected data of 62 subjects included initial and subsequent serum Na+ levels, and rate and Na+ concentration of all intravenous and oral fluids administered until the serum Na+ reached ≤ 150 mEq/L. Median initial serum Na+ was 159.5 mEq/L (IQR 157-163, maximal value 170). The median rate of decline in serum Na+ until serum Na+ reached 150 mEq/L was 0.65 mEq/L/hr (IQR 0.45-0.95). Forty-two children received hypotonic oral fluids which accounted for approximately one-quarter of all fluids they received. There was no significant difference in the rate of decline in serum Na+ between those who consumed oral fluids and those who did not. Neither was there a correlation between the rate of IV fluids, receipt of oral fluids or the degree of dehydration, with the rate of decline in serum Na+. No child experienced an apparent short-term adverse outcome. A cumulative rate of 5.9 mI/kg/hr of IV fluid administration may reduce the serum Na+ by an acceptable rate (0.65 mEq/L/hr). Fluid therapy comprising up to 25% hypotonic oral fluids and 75% IV fluids high in Na+ concentration was not associated with any short-term adverse outcome in our patient population.

A Qualitative Assessment of the Content Validity of the ICECAP-A and EQ-5D-5L and Their Appropriateness for Use in Health Research

PubMed Central

Keeley, Thomas; Al-Janabi, Hareth; Lorgelly, Paula; Coast, Joanna

2013-01-01

Purpose The ICECAP-A and EQ-5D-5L are two index measures appropriate for use in health research. Assessment of content validity allows understanding of whether a measure captures the most relevant and important aspects of a concept. This paper reports a qualitative assessment of the content validity and appropriateness for use of the eq-5D-5L and ICECAP-A measures, using novel methodology. Methods In-depth semi-structured interviews were conducted with research professionals in the UK and Australia. Informants were purposively sampled based on their professional role. Data were analysed in an iterative, thematic and constant comparative manner. A two stage investigation - the comparative direct approach - was developed to address the methodological challenges of the content validity research and allow rigorous assessment. Results Informants viewed the ICECAP-A as an assessment of the broader determinants of quality of life, but lacking in assessment of health-related determinants. The eq-5D-5L was viewed as offering good coverage of health determinants, but as lacking in assessment of these broader determinants. Informants held some concerns about the content or wording of the Self-care, Pain/Discomfort and Anxiety/Depression items (EQ-5D-5L) and the Enjoyment, Achievement and attachment items (ICECAP-A). Conclusion Using rigorous qualitative methodology the results suggest that the ICECAP-A and EQ-5D-5L hold acceptable levels of content validity and are appropriate for use in health research. This work adds expert opinion to the emerging body of research using patients and public to validate these measures. PMID:24367708

78 FR 63228 - Determination That Potassium Citrate, 10 Milliequivalents/Packet and 20 Milliequivalents/Packet...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-23

... approved. ANDA applicants do not have to repeat the extensive clinical testing otherwise necessary to gain... mEq/packet and 20 mEq/packet, is the subject of NDA 19-647, held by Nova-K LLC, and initially...

Emotional intelligence and its correlation to performance as a resident: a preliminary study.

PubMed

Talarico, Joseph F; Metro, David G; Patel, Rita M; Carney, Patricia; Wetmore, Amy L

2008-03-01

To test the hypothesis that emotional intelligence, as measured by the Bar-On Emotional Quotient Inventory (EQ-I) 125 (Multi Health Systems, Toronto, Ontario, Canada) personal inventory, would correlate with resident performance. Prospective survey. University-affiliated, multiinstitutional anesthesiology residency program. Current clinical anesthesiology years one to three (PGY 2-4) anesthesiology residents enrolled in the University of Pittsburgh Anesthesiology Residency Program. Participants confidentially completed the Bar-On EQ-I 125 survey. Results of the individual EQ-I 125 and daily evaluations by the faculty of the residency program were compiled and analyzed. There was no positive correlation between any facet of emotional intelligence and resident performance. There was statistically significant negative correlation (-0.40; P < 0.05) between assertiveness and the "American Board of Anesthesiology essential attributes" component of the resident evaluation. Emotional intelligence, as measured by the Bar-On EQ-I personal inventory, does not strongly correlate to resident performance as defined at the University of Pittsburgh.

Yoga therapy for developing emotional intelligence in mid-life managers.

PubMed

Ganpat, Tikhe Sham; Nagendra, H R

2011-01-01

Business executives' lives have become a never-ending race against time, technology, and targets. This race creates tension, which leads to dissatisfaction and frustration and eventually manifests itself as psychological and physiological stress with mental and emotional drain. This modern lifestyle intensifies the stress leading to "excessive tension" and consequent deterioration in "executive efficiency". To assess emotional intelligent quotient (EQ) in managers undergoing yoga-based Self Management of Excessive Tension (SMET) program. 72 managers participated in this study which is of "single group pre-post design." The EQ test developed by Prof N. K. Chadha from University of Delhi was administered as pre and post the 5 days of SMET program. Means, standard deviations, Kolmogorov-Smirnov test, and Wilcoxon signed rank test were used to analyze the data. The data analysis showed 72.02% significant increase (P<0.001) in EQ. The results suggest that participation in a SMET program was associated with improvement in EQ and may have implications for "executive efficiency."

Physiological responses to dyadic interactions are influenced by neurotypical adults' levels of autistic and empathy traits.

PubMed

Truzzi, Anna; Setoh, Peipei; Shinohara, Kazuyuki; Esposito, Gianluca

2016-10-15

Autistic traits are distributed on a continuum that ranges from non-clinical to clinical condition. Atypical responses to social situations represent a core feature of the Autism Spectrum Disorders phenotype. Here, we hypothesize that atypical physiological responses to social stimuli may predict non-clinical autistic and empathy traits levels. We measured physiological responses (heart rate, facial temperature) of 40 adults (20F) while showing them 24 movies representing dyadic interactions. Autistic traits were assessed through Autism Quotient questionnaire (AQ), while empathy traits were measured using the Empathy Quotient questionnaire (EQ). Opposite correlations between AQ and EQ scores and physiological responses were found. Analysis of physiological responses revealed that individuals with better social abilities, low AQ and high EQ, show opposite activation patterns compared to people with high AQ and low EQ. Findings show that physiological responses could be biomarkers for people's autistic traits and social abilities. Copyright © 2016 Elsevier Inc. All rights reserved.

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

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.

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.

[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.

Contribution to the risk characterization of ciguatoxins: LOAEL estimated from eight ciguatera fish poisoning events in Guadeloupe (French West Indies)

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

Hossen, Virginie; Soliño, Lucia; Leroy, Patricia

From 2010 to 2012, 35 ciguatera fish poisoning (CFP) events involving 87 individuals who consumed locally-caught fish were reported in Guadeloupe (French West Indies). For 12 of these events, the presence of ciguatoxins (CTXs) was indicated in meal remnants and in uncooked fish by the mouse bioassay (MBA). Caribbean ciguatoxins (C-CTXs) were confirmed by liquid chromatography–tandem mass spectrometry (LC–MS/MS) analysis. Using a cell-based assay (CBA), and the only available standard Pacific ciguatoxin-1 (P-CTX-1), the lowest toxins level detected in fish samples causing CFP was 0.022 µg P-CTX-1 equivalent (eq.)·kg{sup −1} fish. Epidemiological and consumption data were compiled for most ofmore » the individuals afflicted, and complete data for establishing the lowest observable adverse effects level (LOAEL) were obtained from 8 CFP events involving 21 individuals. Based on toxin intakes, the LOAEL was estimated at 4.2 ng P-CTX-1 eq./individual corresponding to 48.4 pg P-CTX-1 eq. kg{sup −1} body weight (bw). Although based on limited data, these results are consistent with the conclusions of the European Food Safety Authority (EFSA) opinion which indicates that a level of 0.01 µg P-CTX-1 eq. kg{sup −1} fish, regardless of source, should not exert effects in sensitive individuals when consuming a single meal. The calculated LOAEL is also consistent with the U.S. Food and Drug Administration guidance levels for CTXs (0.1 µg C-CTX-1 eq. kg{sup −1} and 0.01 µg P-CTX-1 eq. kg{sup −1} fish). - Highlights: • We report on an epidemiological study on Ciguatera events in the French West Indies. • The collection of consumption data allows for the first time the LOAEL determination. • The LOAEL for ciguatoxins was established at 48.4 pg P-CTX-1 eq. kg{sup −1} bw. • LC–MS/MS provided structural confirmation of C-CTX1 in two suspected samples • Neuro-2A CBA is suitable for assessing composite toxicity levels in fish samples.« less

Validity of EuroQOL-5D, time trade-off, and standard gamble for age-related macular degeneration in the Singapore population

PubMed Central

Au Eong, K G; Chan, E W; Luo, N; Wong, S H; Tan, N W H; Lim, T H; Wagle, A M

2012-01-01

Background/aims Utility values of age-related macular degeneration (AMD) in Asian patients are unknown. This study aims to assess utility values and construct validity of the EuroQOL-5D (EQ-5D), time trade-off (TTO), and standard gamble (SG) instruments in the Singapore multi-ethnic AMD population. Methods Cross-sectional, two-centre, institution-based study. Visual acuity (VA), clinical AMD severity, and utility scores on the EQ-5D, TTO, and SG were obtained from 338 AMD patients. VA was analysed in terms of the better-seeing eye (BEVA), worse-seeing eye (WEVA), and weighted average of both eyes (WVA). We evaluated SG on the perfect health-death (SG(death)) and binocular perfect vision-binocular blindness (SG(blindness)) scales. Construct validity was determined by testing a priorihypotheses relating the EQ-5D, TTO, and SG utility scores to VA and clinical AMD severity. Results The mean utilities on the EQ-5D, TTO, SG(death), and SG(blindness) were 0.89, 0.81, 0.86, and 0.90, respectively. EQ-5D scores correlated weakly with BEVA, WEVA, and WVA (Pearson's correlation coefficients −0.291, −0.247, and −0.305 respectively, P<0.001 for all). SG(death) and SG(blindness) demonstrated no correlation with BEVA, WEVA, or WVA (Pearson's correlation coefficients, range −0.06 to −0.125). TTO showed weak association only with WEVA and WVA (correlation coefficients −0.237, −0.228, P<0.0001), but not with BEVA (correlation coefficient −0.161). Clinical AMD severity correlated with EQ-5D and SG(death), but not with TTO and SG(blindness) (P=0.004, 0.002, 0.235, and 0.069, respectively). Conclusions AMD has a negative impact on utilities, although utility scores were high compared with Western cohorts. EQ-5D, TTO, and SG showed suboptimal construct validity, suggesting that health status utilities may not be sufficiently robust for cost-utility analyses in this population. PMID:22222257

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

Serum Bicarbonate Is Associated with Heart Failure in the Multi-Ethnic Study of Atherosclerosis.

PubMed

Kendrick, Jessica B; Zelnick, Leila; Chonchol, Michel B; Siscovick, David; Hoofnagle, Andrew N; Ix, Joachim H; Sarnak, Mark; Shlipak, Michael G; Kestenbaum, Bryan; de Boer, Ian H

2017-01-01

Low serum bicarbonate concentrations are associated with mortality and kidney disease progression. Data regarding associations between bicarbonate and cardiovascular disease (CVD) are scarce. We performed a cohort study of 6,229 adult participants from the Multi-Ethnic Study of Atherosclerosis, a community-based cohort free of CVD at baseline. Serum bicarbonate was measured at baseline. Cardiovascular outcomes were defined as: (1) subclinical CVD (left ventricular mass [LVM] and aortic pulse pressure [PP] measured at baseline), (2) incident atherosclerotic cardiovascular events (CVE; composite of myocardial infarction, resuscitated cardiac arrest, stroke, coronary heart disease death, and stroke death), and (3) incident heart failure. During a median (interquartile range) follow-up of 8.5 (7.7-8.6) years, 331 (5.3%) participants had an incident CVE and 174 (2.8%) developed incident heart failure. We stratified analyses by use of diuretics because we observed a significant interaction between diuretic use and bicarbonate with study outcomes. Among diuretic nonusers, with adjustment, bicarbonate ≥25 mEq/L was associated with an estimated 3.0 g greater LVM (95% CI 0.5-5.0) and 1.0 mm Hg higher aortic PP (95% CI 0.4-2.0) compared to bicarbonate 23-24 mEq/L. Each 1 mEq/L of bicarbonate increase was associated with a 13% higher risk of incident heart failure (hazards ratio 1.13, 95% CI 1.01-2.11). Among diuretic users, higher bicarbonate was not associated with CVD. Bicarbonate was not associated with incident atherosclerotic CVE irrespective of diuretic use. Among nonusers of diuretics in a large community-based study, higher serum bicarbonate concentrations are associated with subclinical CVD and new heart failure. © 2016 S. Karger AG, Basel.

Serum Bicarbonate is Associated with Heart Failure in the Multi-Ethnic Study of Atherosclerosis (MESA)

PubMed Central

Kendrick, Jessica; Zelnick, Leila; Chonchol, Michel; Siscovick, David; Hoofnagle, Andrew N.; Ix, Joachim H.; Sarnak, Mark; Shlipak, Michael; Kestenbaum, Bryan; de Boer, Ian H.

2016-01-01

Background Low serum bicarbonate concentrations are associated with mortality and kidney disease progression. Data regarding associations between bicarbonate and cardiovascular disease (CVD) are scarce. Methods We performed a cohort study of 6229 adult participants from MESA (Multi-Ethnic Study of Atherosclerosis), a community-based cohort free of CVD at baseline. Serum bicarbonate was measured at baseline. Cardiovascular outcomes were defined as: 1) subclinical CVD (left ventricular mass (LVM) and aortic pulse pressure (PP) measured at baseline), 2) incident atherosclerotic cardiovascular events (CVE) (composite of myocardial infarction, resuscitated cardiac arrest, stroke, coronary heart disease death and stroke death), and 3) incident heart failure. Results During a median (IQR) follow-up of 8.5 (7.7–8.6) years, 331 (5.3%) participants had an incident CVE and 174 (2.8%) developed incident heart failure. We stratified analyses by use of diuretics because we observed a significant interaction between diuretic use and bicarbonate with study outcomes. Among diuretic nonusers, with adjustment, bicarbonate ≥25 mEq/L was associated with an estimated 3.0 gram greater LVM (95% CI 0.5 to 5.0) and 1.0 mmHg higher aortic PP (95% CI 0.4 to 2.0) compared to bicarbonate 23–24 mEq/L. Each 1mEq/L higher bicarbonate was associated with a 13% higher risk of incident heart failure (HR 1.13, 95% CI 1.01 to 2.11). Among diuretic users, higher bicarbonate was not associated with CVD. Bicarbonate was not associated with incident atherosclerotic CVE irrespective of diuretic use. Conclusion Among nonusers of diuretics in a large community-based study, higher serum bicarbonate concentrations are associated with subclinical CVD and new heart failure. PMID:27941322

Positive feedback of greenhouse gas balances to warming is determined by non-growing season emissions in an alpine meadow

NASA Astrophysics Data System (ADS)

Niu, S.; Wang, J.; Quan, Q.; Chen, W.; Wen, X.; Yu, G.

2017-12-01

Large uncertainties exist in the sources and sinks of greenhouse gases (CO2, CH4, N2O) in response to climate warming and human activity. So far, numerous previous studies have evaluated the CO2 budget, but little attention has paid to CH4 and N2O budgets and the concurrent balance of these three gases in combination, especially in the non-growing season. Here, we synthesized eddy covariance measurement with the automatic chamber measurements of CO2, CH4, and N2O exposed to three levels of temperature treatments (ambient, +1.5 °C, +2.5 °C) and two disturbance treatments (ummowing, mowing) in an alpine meadow on the Tibetan Plateau. We have found that warming caused increase in CH4 uptake and decrease in N2O emission offset little of the enhancement in CO2 emission, triggering a positive feedback to climate warming. Warming switches the ecosystem from a net sink (-17 ± 14 g CO2-eq m-2 yr-1) in the control to a net source of greenhouse gases of 94 ± 36 gCO2-eq m-2 yr-1 in the plots with +1.5 °C warming treatment, and 177 ± 6 gCO2-eq m-2 yr-1 in the plots with +2.5 °C warming treatment. The changes in the non-growing season balance, rather than those in the growing season, dominate the warming responses of annual greehouse gas balance. And this is not changed by mowing. The dominant role of responses of winter greenhouse gas balance in the positive feedback of ecosystem to climate warming highlights that greenhouse gas balance in cold season has to be considered when assessing climate-carbon cycle feedback.

The impacts of anthropogenic emissions on the precipitation chemistry at an elevated site in North-eastern China

NASA Astrophysics Data System (ADS)

Wang, Yan; Wai, Ka Ming; Gao, Jian; Liu, Xiaohuan; Wang, Tao; Wang, Wenxing

Ninety precipitation samples were collected from 2004 to 2006 at the summit of the Mt. Tai in order to detect the impacts of regional sources of pollution on precipitation chemistry in the highly polluted North China Plains. The annual volume-weighted pH of the precipitation was found to be 4.7, in contrast to the less-acidic nature (pH>5.6) of precipitation in northern China reported in many past studies. Non-sea-salt (nss)-SO 42- (131.5 μeq L -1), NH 4+ (82.2 μeq L -1) and Ca 2+ (61.4 μeq L -1) were the most abundant species in precipitation. The wide range of the Cl -/Na + ratios (0.2-5.4) in precipitation implied the co-existence of Cl - enrichment and depletion. The nss-SO 42-, NO 3-, NH 4+, Ca 2+ and K + concentrations peaked in spring, but with the lowest acidity. The very strong correlations of Ca 2+ with nss-SO 42- and NO 3- suggested a significant uptake of nss-SO 42- and NO 3- on dust aerosol during spring. Samples with the lowest pH value (4.5) are associated with the stagnant air conditions. The nss-SO 42- and NH 4+ concentrations at Mt. Tai were the highest compared with those at the EANET, NADP and EMEP sites of similar elevations. With relatively high rainfall amount measured at our site, the high wet deposition of the major acidic/alkaline species exerted large loadings to the ecosystem. The associated impacts on agriculture, soil and aquatic systems should be investigated.

Evidence for deep sub-surface flow routing in forested upland Wales: implications for contaminant transport and stream flow generation

NASA Astrophysics Data System (ADS)

Bridcut, E. E.; McNish, J.; Harriman, R.

2004-06-01

Critical Load (CL) methodology is currently used throughout Europe to assess the risks of ecological damage due to sulphur and nitrogen emissions. Critical acid neutralising capacity (ANCCRIT) is used in CL estimates for freshwater systems as a surrogate for biological damage. Although UK CL maps presently use an ANC value of 0 μeq l-1, this value has been based largely on Norwegian lake studies, in which brown trout is chosen as a representative indicator organism. In this study, an ANC value specific for brown trout in Scottish streams was determined and issues were addressed such as salmon and trout sensitivity in streams, episodicity, afforestation and complicating factors such as dissolved organic carbon (DOC) and labile aluminium (Al-L). Catchments with significant forest cover were selected to provide fishless sites and to provide catchment comparisons in unpolluted areas. Chemical factors were the primary determinant with land use a secondary determinant of the distribution of salmonid populations at the twenty-six study sites. ANC explained more variance in brown trout density than pH. The most significant index of episodicity was percent of time spent below an ANC of 0 μeq l-1. An ANCCRIT value of 39 μeq l-1 was obtained based on a 50% probability of brown trout occurrence. The use of this revised ANCCRIT value in the CL equation improved the relationship between trout status and exceedance of CLs. Uncertainties associated with variations in Al-L at any fixed ANCCRIT, particularly within forested catchments, and the role of DOC in modifying the toxicity of Al-L are discussed.

Emotional intelligence: A unique group training in a hematology-oncology unit.

PubMed

Tadmor, Tamar; Dolev, Niva; Attias, Dina; Lelong, Ayalla Reuven; Rofe, Amnon

2016-01-01

Emotional intelligence (EI) is increasingly viewed as one of the important skills required for a successful career and personal life. Consequently, efforts have been made to improve personal and group performance in EI, mostly in commercial organizations. However, these programs have not been widely applied in the health field. The aim of this study is to assess the impact of a unique special EI interventional process within the framework of an active hematology-oncology unit in a general hospital. This investigation employed a pre- and post-training design using the Bar-On Emotional Quotient Inventory (EQ-i) measure of EI, both before and after completion of training 10 months later. The training included personal and group EI assessments and 10 EI workshops, each 2 weeks apart and each lasting approximately 2 h. Results were compared to a control group of medical staff who did not undergo any EI training program during the same time period. Average total Bar-On EQ-i level at baseline for the group was 97.9, which increased significantly after the interventional process to a score of 105.6 (P = 0.001). There were also significant increases in all five main EQ-i scales, as well as for 12 of the 15 subscales. In contrast, the control group showed no significant differences in general EI level, in any of the five main scales or 15 EI subscale areas. This pilot study demonstrated the capability of a group intervention to improve EI of medical staff working in a hematology-oncological unit. The results are encouraging and suggest that the model program could be successfully applied in a large-scale interventional program.

High-resolution calculations of the solar global convection with the reduced speed of sound technique. I. The structure of the convection and the magnetic field without the rotation

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

Hotta, H.; Yokoyama, T.; Rempel, M., E-mail: hotta.h@eps.s.u-tokyo.ac.jp

2014-05-01

We carry out non-rotating high-resolution calculations of the solar global convection, which resolve convective scales of less than 10 Mm. To cope with the low Mach number conditions in the lower convection zone, we use the reduced speed of sound technique (RSST), which is simple to implement and requires only local communication in the parallel computation. In addition, the RSST allows us to expand the computational domain upward to about 0.99 R {sub ☉}, as it can also handle compressible flows. Using this approach, we study the solar convection zone on the global scale, including small-scale near-surface convection. In particular,more » we investigate the influence of the top boundary condition on the convective structure throughout the convection zone as well as on small-scale dynamo action. Our main conclusions are as follows. (1) The small-scale downflows generated in the near-surface layer penetrate into deeper layers to some extent and excite small-scale turbulence in the region >0.9 R {sub ☉}, where R {sub ☉} is the solar radius. (2) In the deeper convection zone (<0.9 R {sub ☉}), the convection is not influenced by the location of the upper boundary. (3) Using a large eddy simulation approach, we can achieve small-scale dynamo action and maintain a field of about 0.15B {sub eq}-0.25B {sub eq} throughout the convection zone, where B {sub eq} is the equipartition magnetic field to the kinetic energy. (4) The overall dynamo efficiency varies significantly in the convection zone as a consequence of the downward directed Poynting flux and the depth variation of the intrinsic convective scales.« less

A comparison of two different 2400 mOsm solutions for resuscitation of major burns.

PubMed

Milner, S M; Kinsky, M P; Guha, S C; Herndon, D N; Phillips, L G; Kramer, G C

1997-01-01

The reduction of burn edema is a common goal in the resuscitation of patients with thermal injury. Initial infusion of a 2400 mOsm hypertonic 7.5% NaCl 6% dextran (HSD) has been shown to reduce volume needs, but elevated serum sodium levels limit the dose that can be safely used. This study tested the hypothesis that a 2400 mOsm solution of NaCl, amino acids, glucose, and 6% dextran (Isosal-D) would reduce similar volume requirements while maintaining normal plasma sodium levels. Hemodynamics, plasma sodium, fluid balance, and tissue water content were measured after an initial baseline period and during resuscitation of a large scald injury in 21 anesthetized sheep. Resuscitation was begun 30 minutes after the scald with infusion of 10 ml/kg of either lactated Ringer's (LR), Isosal-D, or HSD and was continued with LR to restore and maintain baseline oxygen delivery throughout the 8-hour period. Oxygen delivery, cardiac output, and mean arterial pressure were rapidly reestablished by all three solutions, although a persistent tachycardia was noted with Isosal-D. Net fluid requirements of both HSD (35 +/- 13 ml/kg) and Isosal-D (72 +/- 13 ml/kg) were significantly lower than in the LR group (203 +/- 39 ml/kg). Mean serum sodium increased 11 mEq with HSD to a peak after 4 hours of 152 +/- 5 mEq, whereas with LR sodium fell 7 mEq to 132 +/- 4. Isosal-treated animals had minimal change in serum sodium. HSD significantly decreased tissue water content in colon, liver, pancreas, and nonburned skin compared with LR, whereas Isosal-D reduced edema only in the colon. It is concluded that in this protocol Isosal-D was not as effective as HSD at reducing volume needs and edema and had unexpected chronotropic effects.

Eco-efficient agriculture for producing higher yields with lower greenhouse gas emissions: a case study of intensive irrigation wheat production in China

NASA Astrophysics Data System (ADS)

Cui, Z. L.; Ye, Y. L.; Ma, W. Q.; Chen, X. P.; Zhang, F. S.

2013-10-01

Although the concept of producing higher yields with reduced greenhouse gas (GHG) emissions is a goal that attracts increasing public and scientific attention, the tradeoff between crop productivity and GHG emissions in intensive agricultural production is not well understood. In this study, we investigated 33 sites of on-farm experiments to evaluate the tradeoff between grain yield and GHG emissions using two systems (conventional practice, CP; high-yielding systems, HY) of intensive irrigation wheat (Triticum aestivum L.) in China. Furthermore, we discussed the potential to produce higher yields with lower GHG emissions based on a survey of 2938 farmers. However, in both the HY and CP systems, wheat grain yield response to GHG emissions fit a linear-plateau model, whereas the curve for grain yield from the HY system was always higher than that from the CP system. Compared to the CP system, grain yield was 44% (2.6 Mg ha-1) higher in the HY system, while GHG emissions increased by only 2.5%, and GHG emission intensity was reduced by 29%. The current intensive irrigation wheat system with farmers' practice had a median yield and maximum GHG emission rate of 6.05 Mg ha-1 and 4783 kg CO2 eq ha-1, respectively; however, this system can be transformed to maintain yields while reducing GHG emissions by 40% (5.96 Mg ha-1, and 2890 kg CO2 eq ha-1). Further, the HY system was found to increase grain yield by 41% with a simultaneous reduction in GHG emissions by 38% (8.55 Mg ha-1, and 2961 kg CO2 eq ha-1, respectively). In the future, we suggest moving the tradeoff relationships and calculations from grain yield and GHG emissions, to new measures of productivity and environmental protection using innovative management technologies. This shift in focus is critical to achieve food and environmental security.

Cardiotoxicity of tricyclic antidepressant treated by 2650 mEq sodium bicarbonate: A case report.

PubMed

Amiri, Hassan; Zamani, Nasim; Hassanian-Moghaddam, Hossein; Shadnia, Shahin

2016-01-01

Poisoning with tricyclic antidepressants is an important cause of drug-related self-poisoning in the developed world and a very common cause of poisoning and mortality in developing countries. Electrocardiographic manifestations of most tricyclic antidepressant-poisoned patients resolve by the administration of 1-2 mEq/kg of sodium bicarbonate. Some rare cases have been reported who have been resistant to the long-term or high doses of bicarbonate administration. We present a case of acute tricyclic antidepressant toxicity referring with status epilepticus, hypotension, and refractory QRS complex widening that resolved after the intravenous administration of 2650 mEq sodium bicarbonate.

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

Got EQ?: Increasing Cultural and Clinical Competence through Emotional Intelligence

ERIC Educational Resources Information Center

Robertson, Shari A.

2007-01-01

Cultural intelligence has been described across three parameters of human behavior: cognitive intelligence, emotional intelligence (EQ), and physical intelligence. Each contributes a unique and important perspective to the ability of speech-language pathologists and audiologists to provide benefits to their clients regardless of cultural…

Development of the web-based Spanish and Catalan versions of the Euroqol 5D-Y (EQ-5D-Y) and comparison of results with the paper version.

PubMed

Robles, Noemí; Rajmil, Luis; Rodriguez-Arjona, Dolors; Azuara, Marta; Codina, Francisco; Raat, Hein; Ravens-Sieberer, Ulrike; Herdman, Michael

2015-06-03

The objectives of the study were to develop web-based Spanish and Catalan versions of the EQ-5D-Y, and to compare scores and psychometric properties with the paper version. Web-based and paper versions of EQ-5D-Y were included in a cross-sectional study in Palafolls (Barcelona), Spain and administered to students (n = 923) aged 8 to 18 years from 2 primary and 1 secondary school and their parents. All students completed both the web-based and paper versions during school time with an interval of at least 2 h between administrations. The order of administration was randomized. Participants completed EQ-5D-Y, a measure of mental health status (the Strengths and Difficulties Questionnaire), and sociodemographic variables using a self-administered questionnaire. Parents questionnaire included parental level of education and presence of chronic conditions in children. Missing values, and floor and ceiling effects were compared between versions. Mean score differences were computed for the visual analogue scale (VAS). Percentage of agreement, kappa index (k) and intraclass correlation coefficient (ICC) were computed to analyze the level of agreement between web-based and paper versions on EQ-5D-Y dimensions and VAS. Known groups validity was analyzed and compared between the two formats. Participation rate was 77 % (n = 715). Both formats of EQ-5D-Y showed low percentages of missing values (n = 2, and 4 to 9 for web and paper versions respectively), and a high ceiling effect by dimension (range from 79 % to 96 %). Percent agreement for EQ-5D-Y dimensions on the web and paper versions was acceptable (range 89 % to 97 %), and k ranged from 0.55 (0.48-0.61, usual activities dimension) to 0.75 (0.68-0.82, mobility dimension). Mean score difference on the VAS was 0.07, and the ICC for VAS scores on the two formats was 0.84 (0.82-0.86). Both formats showed acceptable ability to discriminate according to self-perceived health, reporting chronic conditions, and mental health status. The digital EQ-5D-Y showed almost identical VAS scores and acceptable levels of agreement on dimensions. Both formats demonstrated acceptable levels of construct validity. Availability of the Spanish and Catalan web-version will facilitate its use in HRQOL assessment and in economic evaluation.

Effects of disease control by fungicides on greenhouse gas emissions by U.K. arable crop production.

PubMed

Hughes, David J; West, Jonathan S; Atkins, Simon D; Gladders, Peter; Jeger, Michael J; Fitt, Bruce Dl

2011-09-01

The U.K. government has published plans to reduce U.K. agriculture's greenhouse gas (GHG) emissions. At the same time, the goal of global food security requires an increase in arable crop yields. Foliar disease control measures such as fungicides have an important role in meeting both objectives. It is estimated that U.K. winter barley production is associated with GHG emissions of 2770 kg CO2 eq. ha(-1) of crop and 355 kg CO2 eq. t(-1) of grain. Foliar disease control by fungicides is associated with decreases in GHG emissions of 42-60 kg CO2 eq. t(-1) in U.K. winter barley and 29-39 kg CO2 eq. t(-1) in U.K. spring barley. The sensitivity of these results to the impact of disease control on yield and to variant GHG emissions assumptions is presented. Fungicide treatment of the major U.K. arable crops is estimated to have directly decreased U.K. GHG emissions by over 1.5 Mt CO2 eq. in 2009. Crop disease control measures such as fungicide treatment reduce the GHG emissions associated with producing a tonne of grain. As national demand for food increases, greater yields as a result of disease control also decrease the need to convert land from non-arable to arable use, which further mitigates GHG emissions. Copyright © 2011 Society of Chemical Industry.

Life cycle assessment of hemp cultivation and use of hemp-based thermal insulator materials in buildings.

PubMed

Zampori, Luca; Dotelli, Giovanni; Vernelli, Valeria

2013-07-02

The aim of this research is to assess the sustainability of a natural fiber, such as hemp (Cannabis sativa), and its use as thermal insulator for building applications. The sustainability of hemp was quantified by life cycle assessment (LCA) and particular attention was given to the amount of CO2eq of the whole process, and the indicator greenhouse gas protocol (GGP) was selected to quantify CO2eq emissions. In this study also CO2 uptake of hemp was considered. Two different allocation procedures (i.e., mass and economic) were adopted. Other indicators, such as Cumulative Energy Demand (CED) and EcoIndicator99 H were calculated. The production of 1 ha yielded 15 ton of hemp, whose global warming potential (GWP100) was equal to about -26.01 ton CO2eq: the amount allocated to the technical fiber (20% of the total amount of hemp biomass) was -5.52 ton CO2eq when mass allocation was used, and -5.54 ton CO2eq when economic allocation was applied. The sustainability for building applications was quantified by considering an insulation panel made by hemp fiber (85%) and polyester fiber (15%) in 1 m(2) of wall having a thermal transmittance (U) equal to 0.2 W/m(2)_K. The environmental performances of the hemp-based panel were compared to those of a rockwool-based one.

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.

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

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.

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.

Red fluorescent protein eqFP611 and its genetically engineered dimeric variants.

PubMed

Wiedenmann, Jörg; Vallone, Beatrice; Renzi, Fabiana; Nienhaus, Karin; Ivanchenko, Sergey; Röcker, Carlheinz; Nienhaus, G Ulrich

2005-01-01

The red fluorescent protein (FP) eqFP611 from the sea anemone Entacmaea quadricolor shows favorable properties for applications as a molecular marker. Like other anthozoan FPs, it forms tetramers at physiological concentrations. The interactions among the monomers, however, are comparatively weak, as inferred from the dissociation into monomers in the presence of sodium dodecyl sulfate (SDS) or at high dilution. Analysis at the single-molecule level revealed that the monomers are highly fluorescent. For application as fusion markers, monomeric FPs are highly desirable. Therefore, we examine the monomer interfaces in the x-ray structure of eqFP611 to provide a basis for the rational design of monomeric variants. The arrangement of the four beta cans is very similar to that of other green fluorescent protein (GFP-like) proteins such as DsRed and RTMS5. A variety of structural features of the tetrameric interfaces explain the weak subunit interactions in eqFP611. We produce functional dimeric variants by introducing single point mutations in the A/B interface (Thr122Arg, Val124Thr). By contrast, structural manipulations in the A/C interface result in essentially complete loss of fluorescence, suggesting that A/C interfacial interactions play a crucial role in the folding of eqFP611 into its functional form. Copyright 2005 Society of Photo-Optical Instrumentation Engineers

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.

How to Teach Emotional Intelligence Skills in IT Project Management

ERIC Educational Resources Information Center

Connolly, Amy J.; Reinicke, Bryan

2017-01-01

High emotional intelligence ("EQ") is considered one of the greatest strengths of an alpha project manager, yet undergraduate project management students are not directly trained in EQ soft skills such as communication, politics and teamwork. This article describes examples of active learning exercises implemented in an undergraduate IT…

Publisher Correction: Selective enhancement of optical nonlinearity in two-dimensional organic-inorganic lead iodide perovskites.

PubMed

Saouma, F O; Stoumpos, C C; Wong, J; Kanatzidis, M G; Jang, J I

2017-11-23

In the PDF version of this article, Eq. 5 is missing all elements after the equals sign. The correct version of Eq. 5 is given below. The HTML version of the paper was correct from the time of publication.[Formula: see text].