Deriving utility scores for co-morbid conditions: a test of the multiplicative model for combining individual condition scores

BACKGROUND: The co-morbidity of health conditions is becoming a significant health issue, particularly as populations age, and presents important methodological challenges for population health research. For example, the calculation of summary measures of population health (SMPH) can be compromised if co-morbidity is not taken into account. One popular co-morbidity adjustment used in SMPH computations relies on a straightforward multiplicative combination of the severity weights for the individual conditions involved. While the convenience and simplicity of the multiplicative model are attractive, its appropriateness has yet to be formally tested. The primary objective of the current study was therefore to examine the empirical evidence in support of this approach. METHODS: The present study drew on information on the prevalence of chronic conditions and a utility-based measure of health-related quality of life (HRQoL), namely the Health Utilities Index Mark 3 (HUI3), available from Cycle 1.1 of the Canadian Community Health Survey (CCHS; 2000–01). Average HUI3 scores were computed for both single and co-morbid conditions, and were also purified by statistically removing the loss of functional health due to health problems other than the chronic conditions reported. The co-morbidity rule was specified as a multiplicative combination of the purified average observed HUI3 utility scores for the individual conditions involved, with the addition of a synergy coefficient s for capturing any interaction between the conditions not explained by the product of their utilities. The fit of the model to the purified average observed utilities for the co-morbid conditions was optimized using ordinary least squares regression to estimate s. Replicability of the results was assessed by applying the method to triple co-morbidities from the CCHS cycle 1.1 database, as well as to double and triple co-morbidities from cycle 2.1 of the CCHS (2003–04). RESULTS: Model fit was optimized at s = .99 (i.e., essentially a straightforward multiplicative model). These results were closely replicated with triple co-morbidities reported on CCHS 2000–01, as well as with double and triple co-morbidities reported on CCHS 2003–04. CONCLUSION: The findings support the simple multiplicative model for computing utilities for co-morbid conditions from the utilities for the individual conditions involved. Future work using a wider variety of conditions and data sources could serve to further evaluate and refine the approach

The spectra of lifted digraphs

We present a method to derive the complete spectrum of the lift \mathrm{\Gamma\alpha} of a base digraph \mathrm{\Gamma}, with voltage assignment α on a (finite) group $\textit{G}$. The method is based on assigning to \mathrm{\Gamma} a quotient-like matrix whose entries are elements of the group algebra \mathds{C}[$\textit{G}$], which fully represents \mathrm{\Gamma\alpha}. This allows us to derive the eigenvectors and eigenvalues of the lift in terms of those of the base digraph and the irreducible characters of G. Thus, our main theorem generalizes some previous results of Lovász and Babai concerning the spectra of Cayley digraphs

The role of cognitive emotion regulation on the vicarious emotional response

Perceiving another in need may provoke two possible emotional responses: empathic concern and personal distress. This research aims to test whether different emotion regulation strategies (i.e., reappraisal and rumination) may lead to different vicarious emotional responses (i.e., empathic concern and personal distress). In this sense, we hypothesized that reappraisal may lead to a greater feeling of empathic concern, whereas rumination may lead to a higher feeling of personal distress. To test the hypotheses we used experimental instructions (Study 1) and a priming procedure (Study 2) to manipulate the emotion regulation strategies. The results supported our hypotheses. Furthermore in the rumination condition the emotional experience was described as being more negative and more highly arousing than in the reappraisal condition. We discuss the effect of these two forms of cognitive emotion regulation on empathic concern and personal distress

The anomalous U(1) global symmetry and flavors from an SU(5) x SU(5)′' GUT in Z12−IZ_{12-I} orbifold compactification

In string compactifications, frequently there appears the anomalous U(1) gauge symmetry which belonged to E8$\times$E8 of the heterotic string. This anomalous U(1) gauge boson obtains mass at the compactification scale, just below $10^{18\,}$GeV, by absorbing one pseudoscalar (corresponding to the model-independent axion) from the second rank anti-symmetric tensor field $B_{MN}$. Below the compactification scale, there results a global symmetry U(1)$_{\rm anom}$ whose charge $Q_{\rm anom}$ is the original gauge U(1) charge. This is the most natural global symmetry, realizing the "invisible" axion. This global symmetry U(1)$_{\rm anom}$ is suitable for a flavor symmetry. In the simplest compactification model with the flipped SU(5) grand unification, we calculate all the low energy parameters in terms of the vacuum expectation values of the standard model singlets.Comment: 18 pages, 4 figur

Corn and wheat residue management effects on greenhouse gas emissions in the Mid-Atlantic USA

Greenhouse gas (GHG) emissions from crop residue management have been studied extensively, yet the effects of harvesting more than one crop residue in a rotation have not been reported. Here, we measured the short-term changes in methane (CH4), nitrous oxide (N2O), and carbon dioxide (CO2) emissions in response to residue removal from continuous corn (Zea mays L.) (CC) and corn-wheat (Triticum aestivum L.)-soybean (Glycine max L. Merr.) (CWS) rotations in the Mid-Atlantic USA. A first experiment retained five corn stover rates (0, 3.33, 6.66, 10, and 20 Mg ha-1) in a continuous corn (CC) in Blacksburg, VA, in 2016 and 2017. Two other experiments, initiated during the wheat and corn phases of the CWS rotation in New Kent, VA, utilized a factorial combination of retained corn (0, 3.33, 6.66, and 10.0 Mg ha-1) and wheat residue (0, 1, 2, and 3 Mg ha-1). Soybean residue was not varied. Different crop retention rates did not affect CO2 fluxes in any of the field studies. In Blacksburg, retaining 5 Mg ha-1 stover or more increased CH4 and N2O emissions by ~25%. Maximum CH4 and N2O fluxes (4.16 and 5.94 mg m-2 day-1) occurred with 200% (20 Mg ha-1) retention. Two cycles of stover management in Blacksburg, and one cycle of corn or wheat residue management in New Kent did not affect GHG fluxes. This study is the first to investigate the effects of crop residue on GHG emissions in a multi-crop system in humid temperate zones. Longer-term studies are warranted to understand crop residue management effects on GHG emissions in these systems

NIH Disease Funding Levels and Burden of Disease

BACKGROUND: An analysis of NIH funding in 1996 found that the strongest predictor of funding, disability-adjusted life-years (DALYs), explained only 39% of the variance in funding. In 1998, Congress requested that the Institute of Medicine (IOM) evaluate priority-setting criteria for NIH funding; the IOM recommended greater consideration of disease burden. We examined whether the association between current burden and funding has changed since that time. METHODS: We analyzed public data on 2006 NIH funding for 29 common conditions. Measures of US disease burden in 2004 were obtained from the World Health Organization's Global Burden of Disease study and national databases. We assessed the relationship between disease burden and NIH funding dollars in univariate and multivariable log-linear models that evaluated all measures of disease burden. Sensitivity analyses examined associations with future US burden, current and future measures of world disease burden, and a newly standardized NIH accounting method. RESULTS: In univariate and multivariable analyses, disease-specific NIH funding levels increased with burden of disease measured in DALYs (p = 0.001), which accounted for 33% of funding level variation. No other factor predicted funding in multivariable models. Conditions receiving the most funding greater than expected based on disease burden were AIDS ($2474 M), diabetes mellitus ($390 M), and perinatal conditions ($297 M). Depression ($719 M), injuries ($691 M), and chronic obstructive pulmonary disease ($613 M) were the most underfunded. Results were similar using estimates of future US burden, current and future world disease burden, and alternate NIH accounting methods. CONCLUSIONS: Current levels of NIH disease-specific research funding correlate modestly with US disease burden, and correlation has not improved in the last decade

Purpose in life predicts better emotional recovery from negative stimuli

Purpose in life predicts both health and longevity suggesting that the ability to find meaning from life’s experiences, especially when confronting life’s challenges, may be a mechanism underlying resilience. Having purpose in life may motivate reframing stressful situations to deal with them more productively, thereby facilitating recovery from stress and trauma. In turn, enhanced ability to recover from negative events may allow a person to achieve or maintain a feeling of greater purpose in life over time. In a large sample of adults (aged 36-84 years) from the MIDUS study (Midlife in the U.S., http://www.midus.wisc.edu/), we tested whether purpose in life was associated with better emotional recovery following exposure to negative picture stimuli indexed by the magnitude of the eyeblink startle reflex (EBR), a measure sensitive to emotional state. We differentiated between initial emotional reactivity (during stimulus presentation) and emotional recovery (occurring after stimulus offset). Greater purpose in life, assessed over two years prior, predicted better recovery from negative stimuli indexed by a smaller eyeblink after negative pictures offset, even after controlling for initial reactivity to the stimuli during the picture presentation, gender, age, trait affect, and other well-being dimensions. These data suggest a proximal mechanism by which purpose in life may afford protection from negative events and confer resilience is through enhanced automatic emotion regulation after negative emotional provocation

Noise Pollution Filters Bird Communities Based on Vocal Frequency

BACKGROUND: Human-generated noise pollution now permeates natural habitats worldwide, presenting evolutionarily novel acoustic conditions unprecedented to most landscapes. These acoustics not only harm humans, but threaten wildlife, and especially birds, via changes to species densities, foraging behavior, reproductive success, and predator-prey interactions. Explanations for negative effects of noise on birds include disruption of acoustic communication through energetic masking, potentially forcing species that rely upon acoustic communication to abandon otherwise suitable areas. However, this hypothesis has not been adequately tested because confounding stimuli often co-vary with noise and are difficult to separate from noise exposure. METHODOLOGY/PRINCIPAL FINDINGS: Using a natural experiment that controls for confounding stimuli, we evaluate whether species vocal features or urban-tolerance classifications explain their responses to noise measured through habitat use. Two data sets representing nesting and abundance responses reveal that noise filters bird communities nonrandomly. Signal duration and urban tolerance failed to explain species-specific responses, but birds with low-frequency signals that are more susceptible to masking from noise avoided noisy areas and birds with higher frequency vocalizations remained. Signal frequency was also negatively correlated with body mass, suggesting that larger birds may be more sensitive to noise due to the link between body size and vocal frequency. CONCLUSIONS/SIGNIFICANCE: Our findings suggest that acoustic masking by noise may be a strong selective force shaping the ecology of birds worldwide. Larger birds with lower frequency signals may be excluded from noisy areas, whereas smaller species persist via transmission of higher frequency signals. We discuss our findings as they relate to interspecific relationships among body size, vocal amplitude and frequency and suggest that they are immediately relevant to the global problem of increases in noise by providing critical insight as to which species traits influence tolerance of these novel acoustics

The deuteron: structure and form factors

A brief review of the history of the discovery of the deuteron in provided. The current status of both experiment and theory for the elastic electron scattering is then presented.Comment: 80 pages, 33 figures, submited to Advances in Nuclear Physic