Smoking and health-related quality of life in English general population: Implications for economic evaluations

Copyright @ 2012 Vogl et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.This article has been made available through the Brunel Open Access Publishing Fund.Background: Little is known as to how health-related quality of life (HRQoL) when measured by generic instruments such as EQ-5D differ across smokers, ex-smokers and never-smokers in the general population; whether the overall pattern of this difference remain consistent in each domain of HRQoL; and what implications this variation, if any, would have for economic evaluations of tobacco control interventions. Methods: Using the 2006 round of Health Survey for England data (n = 13,241), this paper aims to examine the impact of smoking status on health-related quality of life in English population. Depending upon the nature of the EQ-5D data (i.e. tariff or domains), linear or logistic regression models were fitted to control for biology, clinical conditions, socio-economic background and lifestyle factors that an individual may have regardless of their smoking status. Age- and gender-specific predicted values according to smoking status are offered as the potential 'utility' values to be used in future economic evaluation models. Results: The observed difference of 0.1100 in EQ-5D scores between never-smokers (0.8839) and heavy-smokers (0.7739) reduced to 0.0516 after adjusting for biological, clinical, lifestyle and socioeconomic conditions. Heavy-smokers, when compared with never-smokers, were significantly more likely to report some/severe problems in all five domains - mobility (67%), self-care (70%), usual activity (42%), pain/discomfort (46%) and anxiety/depression (86%) -. 'Utility' values by age and gender for each category of smoking are provided to be used in the future economic evaluations. Conclusion: Smoking is significantly and negatively associated with health-related quality of life in English general population and the magnitude of this association is determined by the number of cigarettes smoked. The varying degree of this association, captured through instruments such as EQ-5D, may need to be fed into the design of future economic evaluations where the intervention being evaluated affects (e.g. tobacco control) or is affected (e.g. treatment for lung cancer) by individual's (or patients') smoking status

Do Word Clues Suffice in Detecting Spam and Phishing?

This paper appeared in the Proceedings of the 8th IEEE Workshop on Information Assurance, West Point, NY, June 2007.Some commercial antispam and anti-phishing products prohibit email from “blacklisted” sites that they claim send spam and phishing email, while allowing email claiming to be from “whitelisted” sites they claim are known not to send it. This approach tends to unfairly discriminate against smaller and less-known sites, and would seem to be anti-competitive. An open question is whether other clues to spam and phishing would suffice to identify it. We report on experiments we have conducted to compare different clues for automated detection tools. Results show that word clues were by far the best clues for spam and phishing, although a little bit better performance could be obtained by supplementing word clues with a few others like the time of day the email was sent and inconsistency in headers. We also compared different approaches to combining clues to spam such as Bayesian reasoning, case-based reasoning, and neural networks; Bayesian reasoning performed the best. Our conclusion is that Bayesian reasoning on word clues is sufficient for antispam software and that blacklists and whitelists are unnecessary.supported in part by the National Science Foundation under the Cyber Trust ProgramApproved for public release; distribution is unlimited

An In Vitro Analysis of a One-Way Arterial Check Valve

The utilization of a centrifugal pump during extracorporeal circulation may result in retrograde blood flow through the circuit. The non-occlusive characteristics of a centrifugal pump could create a condition where regurgitant flow is possible when the pressure in the cannulated vessel exceeded the pressure in the extracorporeal circuit. The reversal of flow, from patient to pump, could entrain air from multiple points including cannulation sites, suture holes, or open vessels or chambers. The following study was conducted to evaluate the ability of an arterial check valve (ACV) to prevent retrograde flow. An in vitro circuit was designed to evaluate the flow dynamics of an ACV under a variety of test conditions including the following: flow rates between 0 and 7.5 L/min, and at temperatures of 37°, 25° and 15°C. The design characteristics of the ACV permitted easy priming, aided by gentle turbulence at the junction of the valve attachment to the casing. There was no difference in pressure drop across the ACV at any flow when compared to an identical circuit without the valve. The pressure drop across the ACV never exceeded 5 mmHg, at any temperature, when flow was less than 2 L/min. Retrograde leak volume was determined by creating "back" pressures on the valve, ranging from 25 to 500 mmHg. One ACV malfunctioned at a back pressure of 250 mmHg, and the data for that valve was omitted for comparative purposes. On the remaining valves, leak volume did not exceed 1.2 ml, and was a result of the compliance of the leaflet structures causing a slight volume displacement due to valve motion in a retrograde fashion. The results of this study show that the ACV permitted unimpeded, unidirectional flow at all operating conditions considered clinically relevant, and may be efficacious in alleviating the chance of retrograde circuit flow

SCALES OF VARIABILITY IN LARVAL SETTLEMENT WITHIN THE CHANNEL ISLANDS NATIONAL MARINE SANCTUARY AND ALONG THE MAINLAND COAST

Abstract-We explored variability in the settlement rates of sea urchins (Strongylocentrotus franciscanus, S. purpuratus), and rock crabs (Cancer spp.) across different spatial (hundreds of meters to 90 km) and temporal (biweekly to decadal) scales in nearshore waters off Santa Cruz, Santa Rosa, and Anacapa islands and along the Santa Barbara mainland coast. Here, we refer to "settlement" as a best estimate of the abundance of small stages of invertebrates recently settled from the plankton. Settlement was measured using two types of collectors: wood-handled scrub brushes and "tuffy" scrub pads attached 1 to 2 m off the bottom either on buoyed mooring lines at stations inside and outside of two marine protected areas (MPAs) at the islands or suspended from piers, one of which is located inside an MPA at Anacapa Island. Benthic recruitment of urchins was also measured at the Anacapa Island station. Larval settlement varied dramatically on a scale of hundreds of meters within and across MPA boundaries. For both red and purple urchins, average settlement at the Santa Cruz and Santa Rosa island sites in 2006 was an order of magnitude higher than average settlement at mainland sites in 2006 and also higher than the historical mainland average (based on a 16-year time series). Comparisons of settlement relative to benthic recruitment at the Anacapa Island station were suggestive of a link for red urchins, but no relationship was evident for purple urchins. Although more data are needed, our results suggest that local and regional scale variability in larval settlement could have important implications for population dynamics, fishery management, MPAs and sampling design. For example, areas with lower settlement rates may take longer to recover depleted populations or be less suitable for restoration efforts based on natural replenishment than areas with greater settlement. Settlement data could provide a fishery-independent measure of stock health and a means for evaluating the role of larval supply in regulating adult populations of economically and ecologically valuable benthic invertebrates

Initial multicenter experience with nitrous oxide cryoballoon for treatment of flat duodenal adenomas (with video)

© 2020 American Society for Gastrointestinal Endoscopy Background and Aims: EMR is the preferred endoscopic therapy for duodenal adenomas (DAs) but is associated with an overall adverse event rate of 26%. Cryotherapy using a Cryoballoon Focal Ablation System (CbFAS) can safely and effectively eradicate esophageal intestinal metaplasia. We report our first experience with cryoballoon ablation for treatment of flat DAs. Methods: This was an American, multicenter, retrospective study involving 5 centers. DAs (Paris 0-IIa and 0-IIb) were treated with nitrous oxide for 5 to 12 seconds using CbFAS. Follow-up EGD was performed at 3 to 12 months. Results: Seventeen DAs (mean size, 22.7 ± 14.3 mm; 12 tubular, 5 tubulovillous) from 13 patients (mean age, 66.5 ± 9.99 years; 61.5% males) were included in the study. Thirteen of 17 DAs (76.5%) had failed previous treatment, and 4 of 17 (23.5%) were treatment naÏve. All procedures were technically successful and achieved a \u3e50% decrease in size after cryoballoon ablation There was no increase in size or progression of disease for any lesions. Overall, treatment was completed in 15 of 17 patients, and recurrence-free survival was achieved in 12 of 17 (71%) after a median follow-up of 15.5 months (interquartile range [IQR], 6.8-19.4). The median cryoablation time per polyp was 4 minutes (IQR, 1-7.5 minutes), and the median total procedure time was 25 minutes (IQR, 22-30.5 minutes). There were no intra- or postprocedural adverse events. Conclusions: Nitrous oxide cryoballoon ablation of nonpolypoid DAs is feasible, with promising safety and efficacy