308 research outputs found
On the value of water quality observations for karst model parameterization
If properly applied, karst hydrological models are a valuable tool for karst water resources management. If they are able to reproduce the relevant flow and storage processes of a karst system, they can be used for prediction of water resources availability when climate or land use are expected to change. A common challenge to apply karst simulation models is the limited availability of observations to identify their model parameters. In this study, we quantify the value of information added to parameter estimation when water quality data (NO3 and SO4) is used in addition to discharge observations to estimate the parameters of a process-based karst simulation model at a test site in Southern Spain. We use a three-step procedure (1) to confine an initial sample of 500,000 model parameter sets, (2) to identify alterations of individual model parameters through the confinement, and (3) to quantify the strength of the confinement for each of the model parameters. The last step allows us to quantify the information content of hydrodynamic and water quality observations for model parameter estimation. Our results show that NO3 provides most information to identify the model parameters controlling soil and epikarst dynamics, while discharge observations provide most information about the recharge area and the groundwater dynamics. SO4 mostly contributes to the identification of recharge processes. Looking at different flow states of the system, we also find that information provided by our observations varies over time.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech
Somatic burden of attention-deficit/hyperactivity disorder across the lifecourse
OBJECTIVE: A thorough and comprehensive knowledge base on the extent of comorbidity of attention-deficit/hyperactivity disorder (ADHD) and somatic conditions is needed.METHOD: We compared the prevalence of a wide range of somatic conditions in individuals with and without ADHD and described sex and lifecourse differences. Individuals with an ADHD diagnosis (N = 87,394) and age and sex-matched individuals without an ADHD diagnosis were identified from a large health claims dataset representative of the general German population, including both primary and specialized care (N = 4.874,754). Results were provided for the full sample as well as stratified for sex and age (<12 years, 13-17 years, 18-29 years, 30-59 years, ≥60 years).RESULTS: The results showed that ADHD is associated with a wide variety of somatic conditions across the entire lifecourse. Specifically neurological disorders such as Parkison's disease (odds ratio [OR]: 5.21) and dementia (OR: 2.23), sleep-related disorders (OR: 2.38) and autoimmune disorders affecting the musculoskeletal, digestive, and endocrine system (fibromyalgia OR: 3.33; lupus OR: 2.17) are strongly and significantly associated with ADHD. Additionally, ADHD is associated with higher occurrence of common acute diseases typically treated by the general practitioner, hinting at an overall general lower health status. Sex differences in somatic comorbidity were not prominent. Age differences, in contrast, stood out: in particular endocrine, cardiovascular, and neurological disorders had an early onset in individuals with compared to individuals without ADHD.CONCLUSION: This research underlines the high burden of disease due to somatic conditions among individuals with ADHD. The findings indicate the need for preventive measures to reduce comorbidity.</p
Disease burden and direct medical costs of incident adult ADHD:A retrospective longitudinal analysis based on German statutory health insurance claims data
Background. Adult attention-deficit/hyperactivity disorder (aADHD) is still a largely unrecognized psychiatric condition despite its strong impact on individuals' well-being. Here, we describe the healthcare situation of individuals with incident aADHD over 4 years before and 4 years after initial administrative diagnosis. Methods. A retrospective, longitudinal cohort analysis was conducted using German claims data. The InGef database contained approximately 5 million member-records from over 60 nationwide statutory health insurances (SHI). Individuals were indexed upon initial diagnosis of aADHD. Results. Average age at diagnosis of aADHD was 35 years, and 60% of individuals were male. Comorbidities, resource use, and healthcare costs were substantial before initial diagnosis and decreased within the 4 years thereafter. Only 32% of individuals received initial ADHD medication and adherence was low. The majority received psychotherapy. Individuals with initial ADHD medication showed the highest share in comorbidities, physician visits, medication use for comorbidities, psychotherapy, and costs. Overall, healthcare costs were at over euro4,000 per individual within the year of aADHD diagnosis. Conclusions. We conclude that earlier recognition of aADHD could prevent the development and aggravation of comorbid mental illnesses. At the same time, comorbid conditions may have masked ("over-shadowed") aADHD and delayed diagnosis. The burden of disease in aADHD is high, which was noticeable especially among individuals who received initial ADHD-medication, suggesting that psychopharmacological treatment was mainly considered for the most severely ill. We conclude that measures to facilitate access of aADHD patients to clinical experts are required to improve reality of care in the outpatient setting
The CRIRES Search for Planets Around the Lowest-Mass Stars. I. High-Precision Near-Infrared Radial Velocities with an Ammonia Gas Cell
Radial velocities measured from near-infrared spectra are a potentially
powerful tool to search for planets around cool stars and sub-stellar objects.
However, no technique currently exists that yields near-infrared radial
velocity precision comparable to that routinely obtained in the visible. We
describe a method for measuring high-precision relative radial velocities of
these stars from K-band spectra. The method makes use of a glass cell filled
with ammonia gas to calibrate the spectrograph response similar to the "iodine
cell" technique that has been used very successfully in the visible. Stellar
spectra are obtained through the ammonia cell and modeled as the product of a
Doppler-shifted template spectrum of the object and a spectrum of the cell,
convolved with a variable instrumental profile model. A complicating factor is
that a significant number of telluric absorption lines are present in the
spectral regions containing useful stellar and ammonia lines. The telluric
lines are modeled simultaneously as well using spectrum synthesis with a
time-resolved model of the atmosphere over the observatory. The free parameters
in the complete model are the wavelength scale of the spectrum, the
instrumental profile, adjustments to the water and methane abundances in the
atmospheric model, telluric spectrum Doppler shift, and stellar Doppler shift.
Tests of the method based on the analysis of hundreds of spectra obtained for
late M dwarfs over six months demonstrate that precisions of ~5 m/s are
obtainable over long timescales, and precisions of better than 3 m/s can be
obtained over timescales up to a week. The obtained precision is comparable to
the predicted photon-limited errors, but primarily limited over long timescales
by the imperfect modeling of the telluric lines.Comment: Accepted for publication in Ap
Serial measurements of midregion proANP and copeptin in ambulatory patients with heart failure: incremental prognostic value of novel biomarkers in heart failure
Prenatal exposure to mixtures of persistent endocrine disrupting chemicals and early menarche in a population-based cohort of British girls
Exposure to endocrine disrupting chemicals (EDCs) is ubiquitous. EDC exposure, especially during critical periods of development like the prenatal window, may interfere with the body’s endocrine system, which can affect growth and developmental outcomes such as puberty. Most studies have examined one EDC at a time in relation to disease; however, humans are exposed to many EDCs. By studying mixtures, the human experience can be more closely replicated. We investigated the association of prenatal exposure to persistent EDCs (poly- and perfluoroalkyl substances (PFAS), polychlorinated biphenyls (PCBs), and organochlorine pesticides (OCPs)) as mixtures with early menarche among female offspring in a nested case-control study within the Avon Longitudinal Study of Parents and Children (ALSPAC) recruited in the United Kingdom in 1991–1992. Concentrations of 52 EDCs were quantified in maternal serum samples collected during pregnancy. Daughter’s age at menarche was ascertained through mailed questionnaires sent annually. We used repeated holdout weighted quantile sum (WQS) regression and Bayesian kernel machine regression (BKMR) to examine the association between prenatal exposure to multiple EDCs and early menarche (<11.5 (n = 218) vs. ≥11.5 years (n = 230)) for each chemical class separately (PFAS, PCBs, and OCPs) and for all three classes combined. Models adjusted for maternal age at menarche, maternal education, parity, pre-pregnancy body mass index, maternal age, prenatal smoking, and gestational week at sample collection. Mixture models showed null associations between prenatal exposure to EDC mixtures and early menarche. Using WQS regression, the odds ratio for early menarche for a one-decile increase in chemical concentrations for all three classes combined was 0.89 (95% CI: 0.76, 1.05); using BKMR, the odds ratio when all exposures were at the 60th percentile compared to the median was 0.98 (95% CI: 0.91, 1.05). Results suggest the overall effect of prenatal exposure to persistent EDC mixtures is not associated with early menarche
De medische kosten van ADHD
Aandachtstekort / hyperactiviteitsstoornis (ADHD) begint in dekindertijd, maar houdt in ongeveer de helft van de gevallen aan involwassenheid. ADHD gaat gepaard met hoge ziektelast, zowel indagelijkse belemmeringen als kosten. Om de medische kosten vanADHD beter in kaart te brengen analyseerden onderzoekers degeanonimiseerde zorgverzekeringsgegevens van 3.7 miljoen Duitsers.De ziektekosten van iemand met ADHD zijn gemiddeld 1508 euro hogerdan die van iemand zonder ADHD. De meeste kosten worden gemaaktin intramurale en extramurale zorg, met medicijnkosten pas op de derdeplaats. Vergeleken met de wereldwijde prevalentie is ADHD bijvolwassenen ondergediagnosticeerd in de Duitse verzekeringsdata. Ditduidt op mogelijke onderherkenning en onderbehandeling van ADHD.De geestelijke gezondheidszorg (GGZ) moet de focus leggen op hetvoorkomen van comorbide stoornissen die met leeftijd toenemen,bijvoorbeeld door de behandling van adolescenten voort te zettengedurende de volwassen leeftijd
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