A disease-specific measure of health-related quality of life for use in adults with immune thrombocytopenic purpura: Its development and validation

BACKGROUND: No validated disease-specific measures are available to assess health-related quality of life (HRQoL) in adult subjects with immune thrombocytopenic purpura (ITP). Therefore, we sought to develop and validate the ITP-Patient Assessment Questionnaire (ITP-PAQ) for adult subjects with ITP. METHODS: Information from literature reviews, focus groups with subjects, and clinicians were used to develop 50 ITP-PAQ items. Factor analyses were conducted to develop the scale structure and reduce the number of items. The final 44-item ITP-PAQ, which includes ten scales [Symptoms (S), Bother-Physical Health (B), Fatigue/Sleep (FT), Activity (A), Fear (FR), Psychological Health (PH), Work (W), Social Activity (SA), Women's Reproductive Health (RH), and Overall (QoL)], was self-administered to adult ITP subjects at baseline and 7–10 days later. Test-retest reliability, internal consistency reliability, construct and known groups validity of the final ITP-PAQ were evaluated. RESULTS: Seventy-three subjects with ITP completed the questionnaire twice. Test-retest reliability, as measured by the intra-class correlation, ranged from 0.52–0.90. Internal consistency reliability was demonstrated with Cronbach's alpha for all scales above the acceptable level of 0.70 (range: 0.71–0.92), except for RH (0.66). Construct validity, assessed by correlating ITP-PAQ scales with established measures (Short Form-36 v.1, SF-36 and Center for Epidemiologic Studies Depression Scale, CES-D), was demonstrated through moderate correlations between the ITP-PAQ SA and SF-36 Social Function scales (r = 0.67), and between ITP-PAQ PH and SF-36 Mental Health Scales (r = 0.63). Moderate to strong inter-scale correlations were reported between ITP-PAQ scales and the CES-D, except for the RH scale. Known groups validity was evaluated by comparing mean scores for groups that differed clinically. Statistically significant differences (p < 0.01) were observed when subjects were categorized by treatment status [S, FT, B, A, PH, and QoL, perceived effectiveness of ITP treatment [S], and time elapsed since ITP diagnosis [PH]. CONCLUSION: Results provide preliminary evidence of the reliability and validity of the ITP-PAQ in adult subjects with ITP. Further work should be conducted to assess the responsiveness and to estimate the minimal clinical important difference of the ITP-PAQ to more fully understand the impact of ITP and its treatments on HRQoL

Aeroservoelastic design definition of a 20 MW common research wind turbine model

Wind turbine upscaling is motivated by the fact that larger machines can achieve lower levelized cost of energy. However, there are several fundamental issues with the design of such turbines, and there is little public data available for large wind turbine studies. To address this need, we develop a 20 MW common research wind turbine design that is available to the public. Multidisciplinary design optimization is used to define the aeroservoelastic design of the rotor and tower subject to the following constraints: blade‐tower clearance, structural stresses, modal frequencies, tip‐speed and fatigue damage at several sections of the tower and blade. For the blade, the design variables include blade length, twist and chord distribution, structural thicknesses distribution and rotor speed at the rated. The tower design variables are the height, and the diameter distribution in the vertical direction. For the other components, mass models are employed to capture their dynamic interactions. The associated cost of these components is obtained by using cost models. The design objective is to minimize the levelized cost of energy. The results of this research show the feasibility of a 20 MW wind turbine and provide a model with the corresponding data for wind energy researchers to use in the investigation of different aspects of wind turbine design and upscaling. Copyright © 2016 John Wiley & Sons, Ltd.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/134256/1/we1970.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/134256/2/we1970_am.pd

Detailed analysis of the blade root flow of a horizontal axis wind turbine

The root flow of wind turbine blades is subjected to complex physical mechanisms that influence significantly the rotor aerodynamic performance. Spanwise flows, the Himmelskamp effect, and the formation of the root vortex are examples of interrelated aerodynamic phenomena that take place in the blade root region. In this study we address those phenomena by means of particle image velocimetry (PIV) measurements and Reynolds-averaged Navier&ndash;Stokes (RANS) simulations. The numerical results obtained in this study are in very good agreement with the experiments and unveil the details of the intricate root flow. The Himmelskamp effect is shown to delay the stall onset and to enhance the lift force coefficient Cl even at moderate angles of attack. This improvement in the aerodynamic performance occurs in spite of the negative influence of the mentioned effect on the suction peak of the involved blade sections. The results also show that the vortex emanating from the spanwise position of maximum chord length rotates in the opposite direction to the root vortex, which affects the wake evolution. Furthermore, the aerodynamic losses in the root region are demonstrated to take place much more gradually than at the tip

Effect of Gait Imagery Tasks on Lower Limb Muscle Activity With Respect to Body Posture

The objective of this study was to evaluate the effect of gait imagery tasks on lowerlimb muscle activity with respect to body posture. The sitting and standing position and lower limb muscle activity were evaluated in 27 healthy female students (24.4±1.3 years, 167.2±5.2 cm, 60.10±6.4 kg). Surface electromyography was assessed during rest and in three different experimental conditions using mental imagery. These included a rhythmic gait, rhythmic gait simultaneously with observation of a model, and rhythmic gait after performing rhythmic gait. The normalized root mean square EMG values with respect to corresponding rest position were compared using non-parametric statistics. Standing gait imagery tasks had facilitatory effect on proximal lower limb muscle activity. However, electromyography activity of distal leg muscles decreased for all gait imagery tasks in the sitting position, when the proprioceptive feedback was less appropriate. For subsequent gait motor imagery tasks, the muscle activity decreased, probably as result of habituation. In conclusion, the effect of motor imagery on muscle activity appears to depend on relative strength of facilitatory and inhibitory inputs

Counting Complex Disordered States by Efficient Pattern Matching: Chromatic Polynomials and Potts Partition Functions

Counting problems, determining the number of possible states of a large system under certain constraints, play an important role in many areas of science. They naturally arise for complex disordered systems in physics and chemistry, in mathematical graph theory, and in computer science. Counting problems, however, are among the hardest problems to access computationally. Here, we suggest a novel method to access a benchmark counting problem, finding chromatic polynomials of graphs. We develop a vertex-oriented symbolic pattern matching algorithm that exploits the equivalence between the chromatic polynomial and the zero-temperature partition function of the Potts antiferromagnet on the same graph. Implementing this bottom-up algorithm using appropriate computer algebra, the new method outperforms standard top-down methods by several orders of magnitude, already for moderately sized graphs. As a first application, we compute chromatic polynomials of samples of the simple cubic lattice, for the first time computationally accessing three-dimensional lattices of physical relevance. The method offers straightforward generalizations to several other counting problems.Comment: 7 pages, 4 figure

Mapping rootable depth and root zone plant-available water holding capacity of the soil of sub-Saharan Africa

In rainfed crop production, root zone plant-available water holding capacity (RZ-PAWHC) of the soil has a large influence on crop growth and the yield response to management inputs such as improved seeds and fertilisers. However, data are lacking for this parameter in sub-Saharan Africa (SSA). This study produced the first spatially explicit, coherent and complete maps of the rootable depth and RZ-PAWHC of soil in SSA. We compiled georeferenced data from 28,000 soil profiles from SSA, which were used as input for digital soil mapping (DSM) techniques to produce soil property maps of SSA. Based on these soil properties, we developed and parameterised (pedotransfer) functions, rules and criteria to evaluate soil water retention at field capacity and wilting point, the soil fine earth fraction from coarse fragments content and, for maize, the soil rootability (relative to threshold values) and rootable depth. Maps of these secondary soil properties were derived using the primary soil property maps as input for the evaluation rules and the results were aggregated over the rootable depth to obtain a map of RZ-PAWHC, with a spatial resolution of 1 km2. The mean RZ-PAWHC for SSA is 74mm and the associated average root zone depth is 96 cm. Pearson correlation between the two is 0.95. RZ-PAWHC proves most limited by the rootable depth but is also highly sensitive to the definition of field capacity. The total soil volume of SSA potentially rootable by maize is reduced by one third (over 10,500 km3) due to soil conditions restricting root zone depth. Of these, 4800 km3 are due to limited depth of aeration, which is the factor most severely limiting in terms of extent (km2), and 2500 km3 due to sodicity which is most severely limiting in terms of degree (depth in cm). Depth of soil to bedrock reduces the rootable soil volume by 2500 km3, aluminium toxicity by 600 km3, porosity by 120 km3 and alkalinity by 20 km3. The accuracy of the map of rootable depth and thus of RZ-PAWHC could not be validated quantitatively due to absent data on rootability and rootable depth but is limited by the accuracy of the primary soil property maps. The methodological framework is robust and has been operationalised such that the maps can easily be updated as additional data become available