911 research outputs found

    Isolation of 10 cyclosporine metabolites from human bile

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    Ten metabolites of cyclosporine were isolated from the ethyl ether extract of bile from four liver transplant patients receiving cyclosporine. Two of the metabolites were unique and previously unidentified. Liquid-liquid partitioning into diethyl ether with subsequent defatting with n-hexane was used for the initial extraction form bile. Separation of the individual metabolites (A-J) was performed using a Sephadex LH-20 column and a gradient high performance liquid chromatographic method. The molecular weights of the isolated metabolites were determined by fast atom bombardment/mass spectrometry. Gas chromatography with mass spectrometic amino acid analysis was also used to identify the amino acid composition and the hydroxylation position of metabolites A, B, C, D, and G. Proton nuclear magnetic resonance spectra were utilized to disinguish the chemical shifts of N-CH3 singlets and NH doublets of metabolites A, B, C, and D. Metabolites A, E, F, H, I, and J were reported previously in human urine and animal bile. Metabolites C and D are dihydroxylated compounds which cannot be clearly described as previously isolated compounds. Metabolites B and G are novel metabolites with a mass fragment which corresponded to a loss of 131 Da from the protonated molecular ion (MH+) in the fast atom bombardment/mass spectrometry, suggesting that the double bond in amino acid 1 has been modified. Metabolites B and G were primarily isolated from the bile of one of the liver transplant patients which contained abnormally high concentrations of these two metabolites. The method described is an efficient procedure for isolating milligram quantities of the major metabolites with greater than 95% purity

    Improving the measurement of QALYs in dementia: developing patient- and carer-reported health state classification systems using Rasch analysis

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    Objectives: Cost-utility analysis is increasingly used to inform resource allocation. This requires a means of valuing health states before and after intervention. Although generic measures are typically used to generate values, these do not perform well with people with dementia. We report the development of a health state classification system amenable to valuation for use in studies of dementia, derived from the DEMQOL system, a measure of health-related quality of life in dementia by patient self-report (DEMQOL) and carer proxy-report (DEMQOL-Proxy). Methods: Factor analysis was used to determine the dimensional structure of DEMQOL and DEMQOL-Proxy. Rasch analysis was subsequently used to investigate item performance across factors in terms of item-level ordering, functioning across subgroups, model fit and severity-range coverage. This enabled the selection of one item from each factor for the classification system. A sample of people with a diagnosis of mild/moderate dementia (n=644) and a sample of carers of those with mild/moderate dementia (n=683) were used. Results: Factor analysis found different 5-factor solutions for DEMQOL and DEMQOL-Proxy. Following item reduction and selection using Rasch analysis, a 5-dimension classification for DEMQOL and a 4-dimension classification for DEMQOL-Proxy were developed. Each item contained 4 health state levels. Conclusion: Combining Rasch and classical psychometric analysis is a valid method of selecting items for dementia health state classifications from both the patient and carer perspectives. The next stage is to obtain preference weights so that the measure can be used in the economic evaluation of treatment, care and support arrangements for dementia.quality adjusted life years; health related quality of life; Rasch analysis; preference-based measures of health; health states; dementia

    Using Rasch analysis to form plausible health states amenable to valuation: the development of CORE-6D from CORE-OM in order to elicit preferences for common mental health problems

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    Purpose: To describe a new approach for deriving a preference-based index from a condition specific measure that uses Rasch analysis to develop health states. Methods: CORE-OM is a 34-item instrument monitoring clinical outcomes of people with common mental health problems. CORE-OM is characterised by high correlation across its domains. Rasch analysis was used to reduce the number of items and response levels in order to produce a set of unidimensionally-behaving items, and to generate a credible set of health states corresponding to different levels of symptom severity using the Rasch item threshold map. Results: The proposed methodology resulted in the development of CORE-6D, a 2-dimensional health state description system consisting of a unidimensionally-behaving 5-item emotional component and a physical symptom item. Inspection of the Rasch item threshold map of the emotional component helped identify a set of 11 plausible health states, which, combined with the physical symptom item levels, will be used for the valuation of the instrument, resulting in the development of a preference-based index. Conclusions: This is a useful new approach to develop preference-based measures where the domains of a measure are characterised by high correlation. The CORE-6D preference-based index will enable calculation of Quality Adjusted Life Years in people with common mental health problems

    Warped Riemannian metrics for location-scale models

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    The present paper shows that warped Riemannian metrics, a class of Riemannian metrics which play a prominent role in Riemannian geometry, are also of fundamental importance in information geometry. Precisely, the paper features a new theorem, which states that the Rao-Fisher information metric of any location-scale model, defined on a Riemannian manifold, is a warped Riemannian metric, whenever this model is invariant under the action of some Lie group. This theorem is a valuable tool in finding the expression of the Rao-Fisher information metric of location-scale models defined on high-dimensional Riemannian manifolds. Indeed, a warped Riemannian metric is fully determined by only two functions of a single variable, irrespective of the dimension of the underlying Riemannian manifold. Starting from this theorem, several original contributions are made. The expression of the Rao-Fisher information metric of the Riemannian Gaussian model is provided, for the first time in the literature. A generalised definition of the Mahalanobis distance is introduced, which is applicable to any location-scale model defined on a Riemannian manifold. The solution of the geodesic equation is obtained, for any Rao-Fisher information metric defined in terms of warped Riemannian metrics. Finally, using a mixture of analytical and numerical computations, it is shown that the parameter space of the von Mises-Fisher model of nn-dimensional directional data, when equipped with its Rao-Fisher information metric, becomes a Hadamard manifold, a simply-connected complete Riemannian manifold of negative sectional curvature, for n=2,,8n = 2,\ldots,8. Hopefully, in upcoming work, this will be proved for any value of nn.Comment: first version, before submissio

    A Global SU(5) F-theory model with Wilson line breaking

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    We engineer compact SU(5) Grand Unified Theories in F-theory in which GUT-breaking is achieved by a discrete Wilson line. Because the internal gauge field is flat, these models avoid the high scale threshold corrections associated with hypercharge flux. Along the way, we exemplify the `local-to-global' approach in F-theory model building and demonstrate how the Tate divisor formalism can be used to address several challenges of extending local models to global ones. These include in particular the construction of G-fluxes that extend non-inherited bundles and the engineering of U(1) symmetries. We go beyond chirality computations and determine the precise (charged) massless spectrum, finding exactly three families of quarks and leptons but excessive doublet and/or triplet pairs in the Higgs sector (depending on the example) and vector-like exotics descending from the adjoint of SU(5)_{GUT}. Understanding why vector-like pairs persist in the Higgs sector without an obvious symmetry to protect them may shed light on new solutions to the mu problem in F-theory GUTs.Comment: 95 pages (71 pages + 1 Appendix); v2 references added, minor correction

    Psychometric properties of the Chinese quality of life instrument (HK version) in Chinese and Western medicine primary care settings

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    Background: The Chinese Quality of Life Measure (ChQOL) had only been validated on a small number of selected subjects in Hong Kong and had never been tested in the Western medicine (WM) primary care setting. Aims: and objectives To test the psychometrics properties of ChQOL(HK version) in both TCM and WM general outpatient clinics. Methods: Three samples of Chinese adult patients [(1) 569 consulting TCM clinics for episodic illnesses; (2) 524 consulting WM clinics for episodic illnesses; (3) 205 consulting WM clinics for chronic disease follow-up] in Hong Kong were invited to complete the ChQOL(HK version) and the SF-36 Health Survey during their consultations and 2 weeks after consultations. The scaling assumptions, factor structure, convergent construct validity, reliability, responsiveness, and discriminatory power of the ChQOL were evaluated. Results: Majority of items satisfied the scaling assumptions. A two instead of 3-factor structure was found with physical form and emotion facets loading on one factor. Convergent construct validity was confirmed with moderate correlations with SF-36 scores. Internal consistency and test-retest reliability were satisfactory. The ChQOL(HK version) was able to detect significant improvements 2 weeks after consultations, and it was able to discriminate between groups with different illness severity, age, and sex. Conclusion The ChQOL(HK version) was shown to have satisfactory validity, reliability, discriminatory power, and responsiveness in both TCM and Western medicine primary care settings. The validity of the 3-domain scaling structure needs further evaluation. © The Author(s) 2011.published_or_final_versionSpringer Open Choice, 21 Feb 201

    Gender Differences in Publication Output: Towards an Unbiased Metric of Research Performance

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    We examined the publication records of a cohort of 168 life scientists in the field of ecology and evolutionary biology to assess gender differences in research performance. Clear discrepancies in publication rate between men and women appear very early in their careers and this has consequences for the subsequent citation of their work. We show that a recently proposed index designed to rank scientists fairly is in fact strongly biased against female researchers, and advocate a modified index to assess men and women on a more equitable basis
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