DIAGNOSIS OF ENDOCRINE DISEASE: Steroid Hormone Analysis in Diagnosis and Treatment of DSD Position Paper of EU COST Action BM 1303 "DSDnet".

Disorders or differences in sex development (DSD) comprise a heterogeneous group of conditions with an atypical sex development. For optimal diagnosis highly specialized laboratory analyses are required across European countries. Working group 3 of EU COST (European Cooperation in Science and Technology) Action BM 1303 "DSDnet" "Harmonisation of Laboratory Assessment" has developed recommendations on laboratory assessment for DSD regarding the use of technologies and analytes to be investigated. This position paper on steroid hormone analysis in diagnosis and treatment of DSD was compiled by a group of specialists in DSD and/or hormonal analysis, either from participating European Countries or international partner countries. The topics discussed comprised analytical methods (immunoassay/mass spectrometry based methods), matrices (urine/serum/saliva) and harmonisation of laboratory tests. The following positions were agreed upon: Support of the appropriate use of immunoassay and mass spectrometry based methods for diagnosis and monitoring of DSD. Serum/plasma and urine are established matrices for analysis. Laboratories performing analyses for DSD need to operate within a quality framework and actively engage in harmonisation processes so that results and their interpretation are the same irrespective of the laboratory they are performed in. Participation in activities of peer comparison such as sample exchange or when available subscribing to a relevant external quality assurance program should be achieved. The ultimate aim of the guidelines is the implementation of clinical standards for diagnosis and appropriate treatment of DSD to achieve the best outcome for patients, no matter where patients are investigated or managed

Tension at the borders: perceptions of role overload, conflict, strain and facilitation in work, family and health roles among employed individuals with arthritis

Objective. To examine inter-relationships among arthritis (A), work (W) and personal life (P) roles and their reciprocal influences, especially experiences of role balance/imbalance among individuals with inflammatory arthritis (IA) and OA

Consistent histories of anthropogenic western European air pollution preserved in different Alpine ice cores

Individual high-Alpine ice cores have been proven to contain a well-preserved history of past anthropogenic air pollution in western Europe. The question of how representative one ice core is with respect to the reconstruction of atmospheric composition in the source region has not been addressed so far. Here, we present the first study systematically comparing longer-term ice-core records (1750–2015 CE) of various anthropogenic compounds, such as major inorganic aerosol constituents (NH4+, NO3-, SO42-), black carbon (BC), and trace species (Cd, F−, Pb). Depending on the data availability for the different air pollutants, up to five ice cores from four high-Alpine sites located in the European Alps analysed by different laboratories were considered. Whereas absolute concentration levels can partly differ depending on the prevailing seasonal distribution of accumulated precipitation, all seven investigated anthropogenic compounds are in excellent agreement between the various sites for their respective, species-dependent longer-term concentration trends. This is related to common source regions of air pollution impacting the four sites less than 100 km away including western European countries surrounding the Alps. For individual compounds, the Alpine ice-core composites developed in this study allowed us to precisely time the onset of pollution caused by industrialization in western Europe. Extensive emissions from coal combustion and agriculture lead to an exceeding of pre-industrial (1750–1850) concentration levels already at the end of the 19th century for BC, Pb, exSO42- (non-dust, non-sea salt SO42-), and NH4+, respectively. However, Cd, F−, and NO3- concentrations started surpassing pre-industrial values only in the 20th century, predominantly due to pollution from zinc and aluminium smelters and traffic. The observed maxima of BC, Cd, F−, Pb, and exSO42- concentrations in the 20th century and a significant decline afterwards clearly reveal the efficiency of air pollution control measures such as the desulfurization of coal, the introduction of filters and scrubbers in power plants and metal smelters, and the ban of leaded gasoline improving the air quality in western Europe. In contrast, NO3- and NH4+ concentration records show levels in the beginning of the 21th century which are unprecedented in the context of the past 250 years, indicating that the introduced abatement measures to reduce these pollutants were insufficient to have a major effect at high altitudes in western Europe. Only four ice-core composite records (BC, F−, Pb, exSO42-) of the seven investigated pollutants correspond well with modelled trends, suggesting inaccuracies of the emission estimates or an incomplete representation of chemical reaction mechanisms in the models for the other pollutants. Our results demonstrate that individual ice-core records from different sites in the European Alps generally provide a spatially representative signal of anthropogenic air pollution trends in western European countries.</p

Eemian Greenland SMB strongly sensitive to model choice

Understanding the behavior of the Greenland ice sheet in a warmer climate, and particularly its surface mass balance (SMB), is important for assessing Greenland's potential contribution to future sea level rise. The Eemian interglacial period, the most recent warmer-than-present period in Earth's history approximately 125&thinsp;000 years ago, provides an analogue for a warm summer climate over Greenland. The Eemian is characterized by a positive Northern Hemisphere summer insolation anomaly, which complicates Eemian SMB calculations based on positive degree day estimates. In this study, we use Eemian global and regional climate simulations in combination with three types of SMB models – a simple positive degree day, an intermediate complexity, and a full surface energy balance model – to evaluate the importance of regional climate and model complexity for estimates of Greenland's SMB. We find that all SMB models perform well under the relatively cool pre-industrial and late Eemian. For the relatively warm early Eemian, the differences between SMB models are large, which is associated with whether insolation is included in the respective models. For all simulated time slices, there is a systematic difference between globally and regionally forced SMB models, due to the different representation of the regional climate over Greenland. We conclude that both the resolution of the simulated climate as well as the method used to estimate the SMB are important for an accurate simulation of Greenland's SMB. Whether model resolution or the SMB method is most important depends on the climate state and in particular the prevailing insolation pattern. We suggest that future Eemian climate model intercomparison studies should include SMB estimates and a scheme to capture SMB uncertainties.</p

A Q-methodology study of flare help-seeking behaviours and different experiences of daily life in rheumatoid arthritis

© 2014 Lin et al.; licensee BioMed Central Ltd. Background: Previous studies have not addressed rheumatoid arthritis (RA) patients' help-seeking behaviours for RA flares, and only one small qualitative study has addressed how patients experience daily life on current treatment regimes. Thus, this study aims to identify clusters of opinion related to RA patients' experiences of daily life on current treatments, and their help-seeking behaviours for RA flares. Methods: Using Q-methodology (a methodology using qualitative and quantitative methods to sort people according to subjective experience), two separate studies were conducted with the same sample of RA patients (mean age 55, 73% female). Thirty participants sorted 39 statements about daily life (Q-study 1) and 29 participants separately sorted 23 statements about flare help-seeking (Q-study 2). Data were examined using Q-factor analysis. Results: Daily life with RA (Q-study 1): Three factors relating to the experience of living with RA were extracted and explained. Patients belonging to Factor A (mean age 62, 86% female) use effective self-management techniques to control the daily impact of RA. Those in Factor B (mean age 55, 75% male) struggle to self-manage and cope. Whilst patients in Factor C (mean age 42, 100% female) prioritise life responsibilities over their RA, reporting less impact. Flare help-seeking (Q-study 2): Two factors explaining the experience of flare help-seeking (unrelated to the factors from Q-study 1) were extracted and explained. Factor X (68.8% on biologics) reported seeking help quickly, believing the medical team is there to help. Factor Y (0% on biologics) delay help-seeking, concerned about wasting the rheumatologist's time, believing they should manage alone. All participants agreed they sought help due to intense pain and persistent, unmanageable symptoms. Conclusions: Patients with different characteristics appear to manage RA life in different ways and men may struggle more than women. Whilst all patients are prompted to seek help by persistent, unmanageable symptoms, some delay help-seeking. Further research is needed to quantify the severity of daily symptoms, the level of symptoms needed for patients to define themselves as in flare and to understand the support needs of RA men

The validation of a new measure quantifying the social quality of life of ethnically diverse older women: two cross-sectional studies

<p>Abstract</p> <p>Background</p> <p>To our knowledge, the available psychometric literature does not include an instrument for the quantification of social quality of life among older women from diverse ethnic backgrounds. To address the need for a tool of this kind, we conducted two studies to assess the initial reliability and validity of a new instrument. The latter was created specifically to quantify the contribution of a) social networks and resources (e.g., family, friends, and community) as well as b) one's perceived power and respect within family and community to subjective well-being in non-clinical, ethnically diverse populations of older women.</p> <p>Methods</p> <p>In Study 1, we recruited a cross-sectional sample of primarily non-European-American older women (<it>N </it>= 220) at a variety of community locations. Participants were administered the following: a short screener for dementia; a demographic list; an initial pool of 50 items from which the final items of the new Older Women's Social Quality of Life Inventory (OWSQLI) were to be chosen (based on a statistical criterion to apply to the factor analysis findings); the Single Item Measure of Social Support (SIMSS); and the Medical Outcome Study 36-item Short-Form Health Survey (MOS SF-36). Study 2 was conducted on a second independent sample of ethnically diverse older women. The same recruitment strategies, procedures, and instruments as those of Study 1 were utilized in Study 2, whose sample was comprised of 241 older women with mostly non-European-American ethnic status.</p> <p>Results</p> <p>In Study 1, exploratory factor analysis of the OWSQLI obtained robust findings: the total variance explained by one single factor with the final selection of 22 items was over 44%. The OWSQLI demonstrated strong internal consistency (<it>α </it>= .92, <it>p </it>< .001), adequate criterion validity with the SIMSS (<it>r </it>= .33; <it>p </it>< .01), and (as expected) moderate concurrent validity with the MOS SF-36 for both physical (<it>r </it>= .21; <it>p </it>< .01) and mental (<it>r </it>= .26; <it>p </it>< .01) quality of life. In order to confirm the validity of the 22-item OWSQLI scale that emerged from Study 1 analyses, we replicated those analyses in Study 2, although using confirmatory factor analysis. The total variance accounted for by one factor was about 42%, again quite high and indicative of a strong single-factor solution. Study 2 data analyses yielded the same strong reliability findings (i.e., <it>α </it>= .92, <it>p </it>< .001). The 22-item OWSQLI was correlated with the SIMSS (<it>r </it>= .27, <it>p </it>< .001) in the expected direction. Finally, correlations with the MOS SF- 36 demonstrated moderate concurrent validity for physical (<it>r </it>= .14; <it>p </it>< .01) and mental (<it>r </it>= .18; <it>p </it>< .01) quality of life, as expected.</p> <p>Conclusions</p> <p>The findings of these two studies highlight the potential for our new tool to provide a valid measure of older women's social quality of life, yet they require duplication in longitudinal research. Interested clinicians should consider using the OWSQLI in their assessment battery to identify older women's areas of lower versus higher social quality of life, and should establish the maximization of patients' social quality of life as an important therapeutic goal, as this variable is significantly related to both physical and mental health.</p

Profiling wind and greenhouse gases by infrared-laser occultation: results from end-to-end simulations in windy air

The new mission concept of microwave and infrared-laser occultation between low-Earth-orbit satellites (LMIO) is designed to provide accurate and long-term stable profiles of atmospheric thermodynamic variables, greenhouse gases (GHGs), and line-of-sight (l.o.s.) wind speed with focus on the upper troposphere and lower stratosphere (UTLS). While the unique quality of GHG retrievals enabled by LMIO over the UTLS has been recently demonstrated based on end-to-end simulations, the promise of l.o.s. wind retrieval, and of joint GHG and wind retrieval, has not yet been analyzed in any realistic simulation setting. Here we use a newly developed l.o.s. wind retrieval algorithm, which we embedded in an end-to-end simulation framework that also includes the retrieval of thermodynamic variables and GHGs, and analyze the performance of both stand-alone wind retrieval and joint wind and GHG retrieval. The wind algorithm utilizes LMIO laser signals placed on the inflection points at the wings of the highly symmetric C¹⁸OO absorption line near 4767 cm^&minus;1 and exploits transmission differences from a wind-induced Doppler shift. Based on realistic example cases for a diversity of atmospheric conditions, ranging from tropical to high-latitude winter, we find that the retrieved l.o.s. wind profiles are of high quality over the lower stratosphere under all conditions, i.e., unbiased and accurate to within about 2 m s^&minus;1 over about 15 to 35 km. The wind accuracy degrades into the upper troposphere due to the decreasing signal-to-noise ratio of the wind-induced differential transmission signals. The GHG retrieval in windy air is not vulnerable to wind speed uncertainties up to about 10 m s^&minus;1 but is found to benefit in the case of higher speeds from the integrated wind retrieval that enables correction of wind-induced Doppler shift of GHG signals. Overall both the l.o.s. wind and GHG retrieval results are strongly encouraging towards further development and implementation of a LMIO mission

The association between COVID-19 policy responses and mental well-being: Evidence from 28 European countries

This study assesses how the implementation and lifting of non-pharmaceutical policy interventions (NPIs), deployed by most governments, to curb the COVID-19 pandemic, were associated with individuals’ mental well-being (MWB) across 28 European countries. This is done both for the general population and across key-groups. We analyze longitudinal data for 15,147 respondents from three waves of the Eurofound-“Living, Working and COVID-19” survey, covering the period April 2020–March 2021. MWB is measured by the WHO-5 index. Our evidence suggests that restriction on international travel, private gatherings, and contact tracing (workplace closures) were negatively (positively) associated with MWB by about, respectively, −0.63 [95% CI: −0.79 to −0.47], −0.24 [95% CI: −0.38 to −0.10], and −0.22 [95% CI: −0.36 to −0.08] (0.29 [95% CI: 0.11 to 0.48]) points. These results correspond to −3.9%, −1.5%, and −1.4% (+1.8%) changes compared to pre-pandemic levels. However, these findings mask important group-differences. Women compared to men fared worse under stay-at-home requirements, internal movement restrictions, private gatherings restrictions, public events cancellation, school closures, and workplace closures. Those residing with children below 12, compared to those who do not, fared worse under public events cancellation, school closures and workplace closures. Conversely, those living with children 12–17, compared to those who do not, fared better under internal movement restrictions and public events cancelling. Western-Europeans vis-à-vis Eastern-Europeans fared better under NPIs limiting their mobility and easing their debts, whereas they fared worse under health-related NPIs. This study provides timely evidence of the rise in inequalities during the COVID-19 pandemic and offers strategies for mitigating them