Responsiveness and convergent validity of QLU-C10D and EQ-5D-3L in assessing short-term quality of life following esophagectomy

Aim: This study assessed the responsiveness and convergent validity of two preference-based measures; the newly developed cancer-specifc EORTC Quality of Life Utility Measure-Core 10 dimensions (QLU-C10D) relative to the generic three-level version of the EuroQol 5 dimensions (EQ-5D-3L) in evaluating short-term health related quality of life (HRQoL) outcomes after esophagectomy. Methods: Participants were enrolled in a multicentre randomised controlled trial to determine the impact of preoperative and postoperative immunonutrition versus standard nutrition in patients with esophageal cancer. HRQoL was assessed seven days before and 42 days after esophagectomy. Standardized Response Mean and Efect Size were calculated to assess responsiveness. Ceiling efects for each dimension were calculated as the proportion of the best level responses for that dimension at follow-up/post-operatively. Convergent validity was assessed using Spearman’s correlation and the level of agreement was explored using Bland–Altman plots. Results: Data from 164 respondents (mean age: 63 years, 81% male) were analysed. HRQoL signifcantly reduced on both measures with large efect sizes (>0.80), and a greater mean diference (0.29 compared to 0.16) on QLU-C10D. Both measures had ceiling efects (>15%) on all dimensions at baseline. Following esophagectomy, ceiling efects were observed with self-care (86%), mobility (67%), anxiety/depression (55%) and pain/discomfort (19%) dimensions on EQ-5D-3L. For QLU-C10D ceiling efects were observed with emotional function (53%), physical function (16%), nausea (35%), sleep (31%), bowel problems (21%) and pain (20%). A strong correlation (r=0.71) was observed between EQ-5D-3L anxiety and QLU-C10D emotional function dimensions. Good agreement (3.7% observations outside the limits of agreement) was observed between the utility scores. Conclusion: The QLU-C10D is comparable to the more widely applied generic EQ-5D-3L, however, QLU-C10D was more sensitive to short-term utility changes following esophagectomy. Cognisant of requirements by policy makers to apply generic utility measures in cost efectiveness studies, the disease-specifc QLU-C10D should be used alongside the generic measures like EQ-5D-3L.Norma B. Bulamu, Ravi Vissapragada, Gang Chen, Julie Ratclife, Louise A. Mudge, B. Mark Smithers, Elizabeth A. Isenring, Lorelle Smith, Glyn G. Jamieson, and David I. Watson, on behalf of The Australian Immunonutrition Study Grou

Phase Behavior of Aqueous Na-K-Mg-Ca-CI-NO3 Mixtures: Isopiestic Measurements and Thermodynamic Modeling

A comprehensive model has been established for calculating thermodynamic properties of multicomponent aqueous systems containing the Na{sup +}, K{sup +}, Mg{sup 2+}, Ca{sup 2+}, Cl{sup -}, and NO{sub 3}{sup -} ions. The thermodynamic framework is based on a previously developed model for mixed-solvent electrolyte solutions. The framework has been designed to reproduce the properties of salt solutions at temperatures ranging from the freezing point to 300 C and concentrations ranging from infinite dilution to the fused salt limit. The model has been parameterized using a combination of an extensive literature database and new isopiestic measurements for thirteen salt mixtures at 140 C. The measurements have been performed using Oak Ridge National Laboratory's (ORNL) previously designed gravimetric isopiestic apparatus, which makes it possible to detect solid phase precipitation. Water activities are reported for mixtures with a fixed ratio of salts as a function of the total apparent salt mole fraction. The isopiestic measurements reported here simultaneously reflect two fundamental properties of the system, i.e., the activity of water as a function of solution concentration and the occurrence of solid-liquid transitions. The thermodynamic model accurately reproduces the new isopiestic data as well as literature data for binary, ternary and higher-order subsystems. Because of its high accuracy in calculating vapor-liquid and solid-liquid equilibria, the model is suitable for studying deliquescence behavior of multicomponent salt systems

Mouse Chromosome 11

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46996/1/335_2004_Article_BF00648429.pd

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Whole-genome sequencing reveals host factors underlying critical COVID-19

Critical COVID-19 is caused by immune-mediated inflammatory lung injury. Host genetic variation influences the development of illness requiring critical care1 or hospitalization2,3,4 after infection with SARS-CoV-2. The GenOMICC (Genetics of Mortality in Critical Care) study enables the comparison of genomes from individuals who are critically ill with those of population controls to find underlying disease mechanisms. Here we use whole-genome sequencing in 7,491 critically ill individuals compared with 48,400 controls to discover and replicate 23 independent variants that significantly predispose to critical COVID-19. We identify 16 new independent associations, including variants within genes that are involved in interferon signalling (IL10RB and PLSCR1), leucocyte differentiation (BCL11A) and blood-type antigen secretor status (FUT2). Using transcriptome-wide association and colocalization to infer the effect of gene expression on disease severity, we find evidence that implicates multiple genes—including reduced expression of a membrane flippase (ATP11A), and increased expression of a mucin (MUC1)—in critical disease. Mendelian randomization provides evidence in support of causal roles for myeloid cell adhesion molecules (SELE, ICAM5 and CD209) and the coagulation factor F8, all of which are potentially druggable targets. Our results are broadly consistent with a multi-component model of COVID-19 pathophysiology, in which at least two distinct mechanisms can predispose to life-threatening disease: failure to control viral replication; or an enhanced tendency towards pulmonary inflammation and intravascular coagulation. We show that comparison between cases of critical illness and population controls is highly efficient for the detection of therapeutically relevant mechanisms of disease

An In Situ Method of Creating Metal Oxide-Carbon Composites and Their Application as Anode Material for Lithium-Ion Batteries

Transition metal oxides are actively investigated as anode materials for lithium-ion batteries (LIBs), and their nanocomposites with carbon frequently show better performance in galvanostatic cycling studies, compared to the pristine metal oxide. An in situ, scalable method for creating a variety of transition metal oxide-carbon nanocomposites has been developed based on free-radical polymerization and cross-linking of poly(acrylonitrile) in the presence of the metal oxide precursor containing vinyl groups. The approach yields a cross-linked polymer network, which uniformly incorporates nanometre-sized transition metal oxide particles. Thermal treatment of the organic-inorganic hybrid material produces nearly monodisperse metal oxide nanoparticles uniformly embedded in a porous carbon matrix. Cyclic voltammetry and galvanostatic cycling electrochemical measurements in a lithium half-cell are used to evaluate the electrochemical properties of a Fe(3)O(4)-carbon composite created using this approach. These measurements reveal that when used as the anode in a lithium battery, the material exhibits stable cycling performance at both low and high current densities. We further show that the polymer/nanoparticle copolymerization approach can be readily adapted to synthesize metal oxide/carbon nanocomposites based on different particle chemistries for applications in both the anode and cathode of LIBs.This material is based on work supported as part of the Energy Materials Center at Cornell, an Energy Frontier Research Center funded by the U.S. Department of Energy, Office of Basic Energy Sciences under Award Number DE-SC0001086. JS acknowledges support from Award No. KUS-C1-018-02 made by King Abdullah University of Science and Technology (KAUST). Facilities available through the Cornell Center for Materials Research (CCMR) were used in the study

The Rechargeable Aluminum-ion Battery

We report a novel aluminium-ion rechargeable battery comprised of an electrolyte containing AlCl3 in the ionic liquid, 1-ethyl-3-methylimidazolium chloride, and a V2O5 nano-wire cathode against an aluminium metal anode. The battery delivered a discharge capacity of 305 mAh g−1 in the first cycle and 273 mAh g−1 after 20 cycles, with very stable electrochemical behaviour.This publication was based on work supported in part by the Energy Materials Center at Cornell, an Energy Frontier Research Center funded by the U.S. Department of Energy, Office of Basic Energy Sciences, under Award Number DE-SC0001086, and by Award No. KUS-C1-018-02, made by King Abdullah University of Science and Technology (KAUST). Facilities available through the Cornell Center for Materials Research (CCMR) were also used for this stud