Paramedics' and pre-hospital physicians' assessments of anatomic injury in trauma patients: a cohort study

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Comparing health-related quality of life in modified Rankin Scale grades : 15D results from 323 patients with brain arteriovenous malformation and population controls

Background We wanted to understand how patients with different modified Rankin Scale (mRS) grades differ regarding their health-related quality of life (HRQoL) and how this affects the interpretation and dichotomization of the grade. Methods In 2016, all adult patients in our brain arteriovenous malformation (AVM) database (n = 432) were asked to fill in mailed letters including a questionnaire about self-sufficiency and lifestyle and the 15D HRQoL questionnaire. The follow-up mRS was defined in 2016 using the electronic patient registry and the questionnaire data. The 15D profiles of each mRS grade were compared to those of the general population and to each other, using ANCOVA with age and sex standardization. Results Patients in mRS 0 (mean 15D score = 0.954 +/- 0.060) had significantly better HRQoL than the general population (mean = 0.927 +/- 0.028), p < 0.0001, whereas patients in mRS 1-4 had worse HRQoL than the general population, p < 0.0001. Patients in mRS 1 (mean = 0.844 +/- 0.100) and mRS 2 (mean = 0.838 +/- 0.107) had a similar HRQoL. In the recently published AVM research, the most commonly used cut points for mRS dichotomization were between mRS 1 and 2 and between mRS 2 and 3. Conclusions Using 15D, we were able to find significant differences in the HRQoL between mRS 0 and mRS 1 AVM patients, against the recent findings on stroke patients using EQ-5D in their analyses. Although the dichotomization cut point is commonly set between mRS 1 and 2, patients in these grades had a similar HRQoL and a decreased ability to continue their premorbid lifestyle, in contrast to patients in mRS 0.Peer reviewe

Computational and experimental performance analysis of a novel method for heating of domestic hot water with a ground source heat pump system

Abstract The paper presents a novel method developed for energy efficient heating of domestic hot water (DHW) with a ground source heat pump (GSHP) system. The method is based on step-based heating of DHW, where the DHW is gradually heated from the inlet temperature of domestic cold water to the target temperature of DHW using a specifically designed GSHP system concept. The developed method was tested and validated using experimental and computational performance analyses and the energy efficiency, operation and potential limitations of the developed application were also studied in existing apartment buildings. To demonstrate the efficiency of the developed application, the performance of the new concept was compared to the performance of a conventionally used GSHP system. The results demonstrated that the developed GSHP concept delivered up to 45–50% improvement in energy efficiency of the DHW heating process over the conventional GSHP application. The measured Seasonal Performance Factors were 2.5–2.6 forthe conventional application and as high as 3.7–3.8 for the developed application, when DHW was heated from 7.5 °C to 55 °C. The case study demonstrated that the developed concept is also well applicable in existing buildings, but there is still room for improvement.Peer reviewe