Convergence between the Penn Alcohol Craving Scale and diagnostic interview for the assessment of alcohol craving.

IntroductionThe Penn Alcohol Craving Scale (PACS) is one of the most widely used instruments to measure craving for alcohol. Recent research has suggested that scores on the PACS can be used as a "stand in" for the diagnostic criterion of alcohol craving with a proposed cutoff of >20 on the PACS indicating a "positive" alcohol craving symptom. The present study examined the convergence between the PACS and face-to-face diagnostic interview for the assessment of alcohol craving.MethodA sample of non-treatment seeking heavy drinkers (N = 338) enrolled in experimental studies of AUD completed the PACS as well as a face-to-face diagnostic interview for AUD, which included the craving item from the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA).ResultsUsing the PACS cut-off score of >20, 12.9% (N = 43) of the sample met criteria for alcohol craving compared to 21% (N = 74) of the sample meeting criteria based on the diagnostic interview. Using the PACS cutoff of >20, sensitivity (i.e., true positive rate) was 41% and specificity (i.e., true negative rate) was 95%. Exploratory analyses suggested that a cut-off score of ≥15 achieved the optimal balance of sensitivity (67%) and specificity (81%) in our sample.ConclusionsAdvancing the assessment of alcohol craving and the conversion from DSM-IV to DSM-5 diagnostic criteria represents an important research direction. The present study recommends that a PACS score cut off of ≥15 should be used as an indicator of clinically significant alcohol craving in community samples of non-treatment seekers

Intranasal melanoma treated with radiation therapy in three dogs

Three dogs were investigated for chronic unilateral nasal discharge. In all cases CT imaging showed an intranasal mass causing turbinate lysis and no evidence of metastasis. Cytology in cases 1 (a 14-year-old neutered male crossbreed dog) and 2 (a five-year-old neutered male German Shepherd dog) demonstrated a pleomorphic cell population with variable intracellular pigment suspicious of melanocytic neoplasia. Histopathology with immunohistochemistry (Melan-A and vimentin, plus PNL-2 in one case) confirmed the diagnosis of melanoma in all dogs. All dogs were treated with megavoltage radiotherapy using linear accelerators. Cases 1 and 3 (a nine-year-old neutered female beagle dog) received a hypofractionated (4 × 8 Gy) protocol and case 2 received a definitive (12 × 4 Gy) protocol. Complete remission was demonstrated on repeat CT scan five months after diagnosis in case 1 and seven months in case 2. Stable disease was documented on CT at four months for case 3; however, clinical signs in this dog remained controlled for 10 months in total. Case 1 died of unrelated causes five months after diagnosis, case 2 was euthanased due to the development of seizures 13 months after diagnosis, and case 3 was lost to follow-up 12 months after diagnosis. Melanoma should be considered as a rare differential diagnosis for primary nasal neoplasia in the dog and radiation therapy can be used as effective local therapy

A Robust Numerical Method for Integration of Point-Vortex Trajectories in Two Dimensions

The venerable 2D point-vortex model plays an important role as a simplified version of many disparate physical systems, including superfluids, Bose-Einstein condensates, certain plasma configurations, and inviscid turbulence. This system is also a veritable mathematical playground, touching upon many different disciplines from topology to dynamic systems theory. Point-vortex dynamics are described by a relatively simple system of nonlinear ODEs which can easily be integrated numerically using an appropriate adaptive time stepping method. As the separation between a pair of vortices relative to all other inter-vortex length scales decreases, however, the computational time required diverges. Accuracy is usually the most discouraging casualty when trying to account for such vortex motion, though the varying energy of this ostensibly Hamiltonian system is a potentially more serious problem. We solve these problems by a series of coordinate transformations: We first transform to action-angle coordinates, which, to lowest order, treat the close pair as a single vortex amongst all others with an internal degree of freedom. We next, and most importantly, apply Lie transform perturbation theory to remove the higher-order correction terms in succession. The overall transformation drastically increases the numerical efficiency and ensures that the total energy remains constant to high accuracy.Comment: 21 pages, 4 figure

Acute effects of Hibiscus sabdariffa calyces on postprandial blood pressure, vascular function, blood lipids, biomarkers of insulin resistance and inflammation in humans

The acute impact of Hibiscus sabdariffa calyces (HSC) extract on postprandial vascular function and other cardiometabolic risk factors have not been studied previously. This study investigated the acute impact of HSC extract consumption on blood pressure (BP), vascular function and other cardiometabolic risk markers. Twenty-five men with 1% to 10% cardiovascular disease (CVD) risk (determined by QRISK 2) were randomised to consume either 250 mL of the aqueous extract of HSC or water with breakfast in a randomised, controlled, single-blinded, 2-meal cross-over study (ClinicalTrials.gov, NTC02165553) with a two weeks washout period between study days. BP was measured at baseline and hourly for 4 h. Flow mediated dilatation (FMD) of the branchial artery was measured at baseline, 2 and 4 h post intervention drink consumption. Acute consumption of aqueous extract of HSC caused a significant increase in % FMD ( < 0.001), a non-significant decrease in systolic BP (SBP) and diastolic BP (DBP); non-significant increase in urinary and plasma nitric oxide (NOx) and reduced response of serum glucose, plasma insulin, serum triacylglycerol and C-reactive protein (CRP) levels; significant ( = 0.026) improvement in the area under systemic antioxidant response curve (0 to 2 h); no significant changes in arterial stiffness following the acute consumption of the extract of HSC. Gallic acid, 4-O-methylgallic acid, 3-O-methylgallic acid and hippuric acid reached a maximum plasma concentration at 1 to 2 h post consumption of the extract of HSC. The extract of HSC improved postprandial vascular function and may be a useful dietary strategy to reduce endothelial dysfunction and CVD risk, although this requires confirmation

Estimating a Preference-Based Index for an Eight-Dimensional Health State Classification System for Multiple Sclerosis.

PublishedJournal ArticleBACKGROUND: Condition-specific measures are frequently used to assess the health-related quality of life of people with multiple sclerosis (MS). Such measures are unsuitable for use in economic evaluations that require estimates of cost per quality-adjusted life-year because they are not based on preferences. OBJECTIVES: To report the estimation of a preference-based single index for an eight-dimensional instrument for MS, the Multiple Sclerosis Impact Scale - Eight Dimensions (MSIS-8D), derived from an MS-specific measure of health-related quality of life, the 29-item Multiple Sclerosis Impact Scale (MSIS-29). METHODS: We elicited preferences for a sample of MSIS-8D states (n = 169) from a sample (n = 1702) of the UK general population. Preferences were elicited using the time trade-off technique via an Internet-based survey. We fitted regression models to these data to estimate values for all health states described by the MSIS-8D. Estimated values were assessed against MSIS-29 scores and values derived from generic preference-based measures in a large, representative sample of people with MS. RESULTS: Participants reported that the time trade-off questions were easy to understand. Observed health state values ranged from 0.08 to 0.89. The best-performing model was a main effects, random effects model (mean absolute error = 0.04). Validation analyses support the performance of the MSIS-8D index: it correlated more strongly than did generic measures with MSIS-29 scores, and it discriminated effectively between subgroups of people with MS. CONCLUSIONS: The MSIS-8D enables health state values to be estimated from the MSIS-29, adding to the methods available to assess health outcomes and to estimate quality-adjusted life-years for MS for use in health technology assessment and decision-making contexts

Quality management approach in construction equipment manufacturing

Over the recent decades, quality management practises have been documented extensively, with concepts often being termed the latest management fad. This study tackles a debate that has been a topic of discussion within academic literature for several decades; is Total Quality Management a management fad, which should be replaced by a new quality philosophy. This paper presents the TQM versus Six Sigma debate, by critically reviewing existing literature on the two approaches, as well as providing results from research within a leading construction equipment manufacturer. The results highlight that Six Sigma should be implemented using TQM as a foundation; thus presenting the overall finding that TQM and Six Sigma are compliments, not substitutes