Psychometric properties of the disease-specific health-related quality of life instrument VascuQoL in a Swedish setting

Background: Traditional outcome measures in peripheral arterial disease (PAD) provide insufficient information regarding patient benefit. It has therefore been suggested to add patient-reported outcome measures. The main aim of this study was to validate the Swedish Vascular Quality of Life questionnaire (VascuQoL) version, a patient-reported PAD-specific health-related quality of life (HRQoL) instrument. Methods: Two-hundred PAD patients were consecutively recruited from two university hospitals. Out of the 200 subjects, 129 had intermittent claudication and 71 had critical limb ischemia. Mean age was 70 +/- 9 y and 57% of the participants were male. All patients completed SF-36 and VascuQoL at the vascular outpatient clinic, when evaluated for invasive treatment. Risk factors and physiological parameters were registered. Construct validity was tested by correlation analysis versus SF-36 and was also assessed with multitrait/multi-item scaling analysis (MTMI). Sensitivity analysis regarding disease severity identification was performed. Reliability was assessed with Cronbach's alpha and responsiveness by standardized response mean (SRM) calculations. Results: Significant correlations were demonstrated between relevant subscales of VascuQoL and SF-36. MTMI showed acceptable construct validity, but some scaling-errors. VascuQoL significantly (p < 0.001) discriminated claudicants from critical limb ischemia patients. Cronbach's alpha was 0.94 and SRM 1.02 (sum score). Conclusions: The Swedish version of VascuQoL is valid and quantifies central aspects of HRQoL in PAD patients. Sensitivity analysis showed high ability to differentiate between disease severity and SRM illustrated excellent responsiveness. The relative abundance of items however makes use in the everyday clinical setting somewhat difficult

Comparison of Brief Cognitive Tests and CSF Biomarkers in Predicting Alzheimer’s Disease in Mild Cognitive Impairment: Six-Year Follow-Up Study

INTRODUCTION: Early identification of Alzheimer's disease (AD) is needed both for clinical trials and in clinical practice. In this study, we compared brief cognitive tests and cerebrospinal fluid (CSF) biomarkers in predicting conversion from mild cognitive impairment (MCI) to AD. METHODS: At a memory clinic, 133 patients with MCI were followed until development of dementia or until they had been stable over a mean period of 5.9 years (range 3.2-8.8 years). The Mini-Mental State Examination (MMSE), the clock drawing test, total tau, tau phosphorylated at Thr(181) (P-tau) and amyloid-β(1-42) (Aβ(42)) were assessed at baseline. RESULTS: During clinical follow-up, 47% remained cognitively stable and 53% developed dementia, with an incidence of 13.8%/year. In the group that developed dementia the prevalence of AD was 73.2%, vascular dementia 14.1%, dementia with Lewy bodies (DLB) 5.6%, progressive supranuclear palsy (PSP) 4.2%, semantic dementia 1.4% and dementia due to brain tumour 1.4%. When predicting subsequent development of AD among patients with MCI, the cognitive tests classified 81% of the cases correctly (AUC, 0.85; 95% CI, 0.77-0.90) and CSF biomarkers 83% (AUC, 0.89; 95% CI, 0.82-0.94). The combination of cognitive tests and CSF (AUC, 0.93; 95% CI 0.87 to 0.96) was significantly better than the cognitive tests (p = 0.01) and the CSF biomarkers (p = 0.04) alone when predicting AD. CONCLUSIONS: The MMSE and the clock drawing test were as accurate as CSF biomarkers in predicting future development of AD in patients with MCI. Combining both instruments provided significantly greater accuracy than cognitive tests or CSF biomarkers alone in predicting AD

AGR2, an Endoplasmic Reticulum Protein, Is Secreted into the Gastrointestinal Mucus

The MUC2 mucin is the major constituent of the two mucus layers in colon. Mice lacking the disulfide isomerase-like protein Agr2 have been shown to be more susceptible to colon inflammation. The Agr2(-/-) mice have less filled goblet cells and were now shown to have a poorly developed inner colon mucus layer. We could not show AGR2 covalently bound to recombinant MUC2 N- and C-termini as have previously been suggested. We found relatively high concentrations of Agr2 in secreted mucus throughout the murine gastrointestinal tract, suggesting that Agr2 may play extracellular roles. In tissue culture (CHO-K1) cells, AGR2 is normally not secreted. Replacement of the single Cys in AGR2 with Ser (C81S) allowed secretion, suggesting that modification of this Cys might provide a mechanism for circumventing the KTEL endoplasmic reticulum retention signal. In conclusion, these results suggest that AGR2 has both intracellular and extracellular effects in the intestine

Om datering av Gotlands medeltida kyrkor

About Dating the Medieval Churches of Gotland By Heikki Ranta, Joakim Hansson, Alf Lindroos, Åsa Ringbom, Jan Heinemeier, Fiona Brock &amp; Gregory Hodgins In 2006 the project »Mortar dating of the Gotland churches« was initiated, with the aim to test how mortar dating would work in a geological area so dominated by Silurian limestone, and how the results of this method could affect the prevailing chronology of the churches. Initial testing was done on three different churches, the church of Bro in the northern part of the island, and with Hamra and Vamlingbo in the south. The result is that mortar based on Silurian limestone behaves much the same way as mortar including Åland Ordovician limestone. Thus, based on mortar dating a chronology of the church of Bro can be seen as follows: A Romanesque nave from ca AD 1040-1160, with an almost contemporary tower in the west, with an additional chancel in the east from the 13th century. In the church of Hamra, the lower part of the west tower, and possibly also the earlier part of a cruciform plan, dates from 1165-1220. Later, in 1260-80, the tower was heightened. The chancel in the east is an addition from the 14th century. In Vamlingbo, the focus was on a secondary support construction of disputed age, built against a south portal. This time the mortar was contaminated by unburned limestone, and the result of mortar dating remains inconclusive. However, fragments of wood and charcoal, incapsuled in the mortar, suggest a terminus post quem some time in the 14th century. It is most likely that the supporting wall is a medieval construction. At this initial stage it seems that the results of mortar dating in turn support earlier prevailing views on the chronology. The results also coincide with occasional dendrochronological dates and with contemporary inscriptions in the churches. It seems that mortar dating can be a helpful tool in forming an objective base for a chronology of the Gotland churches

Negotiating Complexity in Test Automation Tool Support - A Design Research Approach

Fully realizing the vision of agile processes might require practical tool support to enable activities like test driven design, refactoring, and regression testing. In this paper we will examine in detail, the design process of developing a test automation framework for a company in need of reducing time consuming manual testing. By employing an iterative research process, we will investigate and present what considerations, in both practice and academia, must be taken in order to reach a suitable tool design. The depth of the problem is acknowledged and, as we will see, calls for a complex design process. This process, along with the framework design, is comprehensibly described within this paper. In addition, we will also assess the framework’s potential impact on the company’s work process

Funktionalitet i en farmtida version av DisCo

DisCo är ett webbaserat program som utvecklades på Högskolan i Trollhättan/Uddevalla och vars syfte är att hjälpa lärare i deras arbete genom att man där kan publicera kursmaterial och kommunicera med studenter. Systemet började användas 1998 som ett verktyg vid distansundervisningen. Idag har vissa problem uppstått på tekniksidan och på grund av detta har HTU inlett ett arbete med att utveckla DisCo. Som en del i detta utvecklingsarbete gav de oss i uppdrag att undersöka vilken funktionalitet som bör finnas i en framtida version av DisCo. För att uppfylla syftet med uppsatsen valde vi att undersöka följande fråga: Vilken upplevd saknad funktionalitet bör införas i en framtida version av DisCo? Vi valde även att ta med följande delfrågor för att få en djupare förståelse av den nuvarande funktionaliteten: Vad upplevs idag vara bra med DisCo och hur kan detta bevaras? Vilka brister upplevs idag i DisCo och hur bör dessa åtgärdas? För att uppfylla syftet, vilket vi bedömer oss ha lyckats med, genomförde vi kvalitativa intervjuer med lärare och studenter samt en mindre jämförelse med systemen WebCT och TopClass. De slutsatser vi anser viktigast är:Införandet av funktioner för gruppbokning, kursutvärdering, FAQ, schema och chat, att bibehålla enkelhet och användarvänlighet genom att en omstrukturering av funktioner till moduler och gamla kurssidor bör arkiveras