The psychometric properties of ADCS - activities of daily living inventory and comparison of different ADL scores

Several multi-item activities of daily living (ADL) scales have been developed for assessment of functional status of patients with Alzheimer’s Disease (AD) in the last few decades. A disadvantage of the large number of scales is that scores of different ADL scales cannot be compared directly with each other. ADL scales which are used by McNamee’s (Townsend's disability scale) and Hill’s (Medicare Beneficiary definitions and Katz index of ADL) provide suitable tools for modelling the cost-effectiveness of different treatments in patients with Alzheimer’s disease, since they report empirical results about the relationship between the degree of functional impairment (healthcare costs) and the prevalence of institutionalisation. The IDEAL trial examines the efficacy of Exelon Patch with the ADCS - Activities of Daily Living Inventory (ADCS-ADL). This ADL instrument is not directly comparable to the ADL scales used by McNamee and Hill. However, the use of the ADL scale from the IDEAL study to predict the prevalence of institutionalisation with scales by Hill and McNamee would be desirable. Because of the generic nature of the ADL construct, and considering the fact that these well validated ADL instruments identify the main physical impairments and functional disabilities in Alzheimer's disease, we should expect high overlap in item content between different ADL instruments. The high overlap in item content between instruments, and the similar wording and scoring criteria, makes it possible to pair each impairment with another. The intention of this study was to establish the link between these ADL scales in order to provide appropriate conditions for further economic analyses on the dataset provided by the IDEAL study

The dynamics of surges in the 3 February 2015 avalanches in Vallee de la Sionne

Five avalanches were artificially released at the Vallée de la Sionne test site in the west of Switzerland on 3 February 2015 and recorded by the GEOphysical flow dynamics using pulsed Doppler radAR Mark 3 radar system. The radar beam penetrates the dilute powder cloud and measures reflections from the underlying denser avalanche features allowing the tracking of the flow at 111 Hz with 0.75 m downslope resolution. The data show that the avalanches contain many internal surges. The large or “major” surges originate from the secondary release of slabs. These slabs can each contain more mass than the initial release, and thus can greatly affect the flow dynamics, by unevenly distributing the mass. The small or “minor” surges appear to be a roll wave-like instability, and these can greatly influence the front dynamics as they can repeatedly overtake the leading edge. We analyzed the friction acting on the fronts of minor surges using a Voellmy-like, simple one-dimensional model with frictional resistance and velocity-squared drag. This model fits the data of the overall velocity, but it cannot capture the dynamics and especially the slowing of the minor surges, which requires dramatically varying effective friction. Our findings suggest that current avalanche models based on Voellmy-like friction laws do not accurately describe the physics of the intermittent frontal region of large mixed avalanches. We suggest that these data can only be explained by changes in the snow surface, such as the entrainment of the upper snow layers and the smoothing by earlier flow fronts

Hyperglycemia and Death in Cystic Fibrosis–Related Diabetes

OBJECTIVE Diabetes is common in cystic fibrosis and increases the risk of death, yet the role of hyperglycemia remains unproven. An association between glycemia and mortality would provide compelling evidence to support glucose lowering in cystic fibrosis–related diabetes (CFRD). RESEARCH DESIGN AND METHODS Using the U.K. Cystic Fibrosis Registry, we analyzed longitudinal data from 2006 to 2009 in 520 individuals with diabetes. We tested the association between HbA1c and mortality. RESULTS During a median follow-up of 2 years, 36 patients died. The median value of HbA1c was higher in those who died (7.3%) than in those who did not (6.7%). An HbA1c value of ≥6.5% was associated with a threefold increased risk of death (hazard ratio 3.2 [95% CI 1.4–7.3]; P = 0.005) independent of potential confounders. CONCLUSIONS Hyperglycemia trebles the risk of death in patients with CFRD. These findings provide epidemiologic support for continued efforts to improve glycemic control. Diabetes frequently complicates cystic fibrosis. Cystic fibrosis–related diabetes (CFRD) has an incidence in teenagers of up to 6% per year and a prevalence in adults of >30% (1,2). Diabetes further elevates the already high mortality rates in cystic fibrosis (3–5). In individuals without cystic fibrosis, diabetes increases the risk of death, and in individuals with diabetes, hyperglycemia increases the risk of death (6,7). However, no study of CFRD using national data has investigated whether hyperglycemia, per se, increases the risk of death; likewise, no trial has tested whether controlling blood glucose prolongs survival. Proving an association between glycemia and mortality in cystic fibrosis would provide compelling observational evidence to inform clinical practice. Using the U.K. Cystic Fibrosis Registry, we performed longitudinal analyses to test the association between glycemia, as measured by HbA1c, and mortality in individuals with CFRD

Art, Artifact, Archive: African American Experiences in the Nineteenth Century

Angelo Scarlato’s extraordinary and vast collection of art and artifacts related to the Civil War, and specifically to the Battle of Gettysburg, the United States Colored Troops, slavery and the African American struggle for emancipation, citizenship and freedom has proved to be an extraordinary resource for Gettysburg College students. The 2012-14 exhibition in Musselman Library’s Special Collections, curated by Lauren Roedner ’13, entitled Slaves, Soldiers, Citizens: African American Artifacts of the Civil War Era and its corresponding catalogue provided a powerful and comprehensive historical narrative of the period. This fall, students in my course at Gettysburg College “Art and Public Policy”—Diane Brennan, Maura Conley, Abigail Conner, Nicole Conte, Victoria Perez-Zetune, Savannah Rose, Kaylyn Sawyer, Caroline Wood and Zoe Yeoh—selected additional objects of material and print culture from Angelo’s private collection and drew from Lauren’s expertise for the exhibition Art, Artifact, Archive: African American Experiences in the Nineteenth Century to investigate public representations of a newly freed population as well as their more personal perspectives. [excerpt]https://cupola.gettysburg.edu/artcatalogs/1015/thumbnail.jp

Viscosity solutions of systems of PDEs with interconnected obstacles and Multi modes switching problems

This paper deals with existence and uniqueness, in viscosity sense, of a solution for a system of m variational partial differential inequalities with inter-connected obstacles. A particular case of this system is the deterministic version of the Verification Theorem of the Markovian optimal m-states switching problem. The switching cost functions are arbitrary. This problem is connected with the valuation of a power plant in the energy market. The main tool is the notion of systems of reflected BSDEs with oblique reflection.Comment: 36 page

That\u27s a Lot of Bunk / words by Al Wilson, James A. Brennan, and Mack Henshaw

Cover: photo of James Barton, a Caucasian male in blackface; cartoon drawings satirizing ideas such as taxi drivers never cheat or landlords never raise the rent; Publisher: Edward B. Marks Music Co. (New York)https://egrove.olemiss.edu/sharris_d/1050/thumbnail.jp