EQ-5D in Central and Eastern Europe : 2000-2015

Objective: Cost per quality-adjusted life year data are required for reimbursement decisions in many Central and Eastern European (CEE) countries. EQ-5D is by far the most commonly used instrument to generate utility values in CEE. This study aims to systematically review the literature on EQ-5D from eight CEE countries. Methods: An electronic database search was performed up to July 1, 2015 to identify original EQ-5D studies from the countries of interest. We analysed the use of EQ-5D with respect to clinical areas, methodological rigor, population norms and value sets. Results: We identified 143 studies providing 152 country-specific results with a total sample size of 81,619: Austria (n=11), Bulgaria (n=6), Czech Republic (n=18), Hungary (n=47), Poland (n=51), Romania (n=2), Slovakia (n=3) and Slovenia (n=14). Cardiovascular (20%), neurologic (16%), musculoskeletal (15%) and endocrine/nutritional/metabolic diseases (14%) were the most frequently studied clinical areas. Overall 112 (78%) of the studies reported EQ VAS results and 86 (60%) EQ-5D index scores, of which 27 (31%) did not specify the applied tariff. Hungary, Poland and Slovenia have population norms. Poland and Slovenia also have a national value set. Conclusions: Increasing use of EQ-5D is observed throughout CEE. The spread of health technology assessment activities in countries seems to be reflected in the number of EQ-5D studies. However, improvement in informed use and methodological quality of reporting is needed. In jurisdictions where no national value set is available, in order to ensure comparability we recommend to apply the most frequently used UK tariff. Regional collaboration between CEE countries should be strengthened

An Observational Overview of Solar Flares

We present an overview of solar flares and associated phenomena, drawing upon a wide range of observational data primarily from the RHESSI era. Following an introductory discussion and overview of the status of observational capabilities, the article is split into topical sections which deal with different areas of flare phenomena (footpoints and ribbons, coronal sources, relationship to coronal mass ejections) and their interconnections. We also discuss flare soft X-ray spectroscopy and the energetics of the process. The emphasis is to describe the observations from multiple points of view, while bearing in mind the models that link them to each other and to theory. The present theoretical and observational understanding of solar flares is far from complete, so we conclude with a brief discussion of models, and a list of missing but important observations.Comment: This is an article for a monograph on the physics of solar flares, inspired by RHESSI observations. The individual articles are to appear in Space Science Reviews (2011

Deriving effective sunspot temperatures from SOHO/VIRGO irradiance measurements

A method is developed to obtain mean effective sunspot temperatures from satellite irradiance deficits. Using a formalism derived from a star spot modelling approach, this method only requires accurate positions and areas of sunspots – but not intensities. The method is applied to SOHO/VIRGO spectral solar irradiance (SSI) at 402, 500, and 862 nm as well as total solar irradiance (TSI) measured during the period 16 July to 17 August 1996, the disk passage of active region NOAA 7981. MDI full disk white-light images are used to extract sunspot positions and areas. First, using the spot pixels, which are identified on MDI images as ${ I_{\rm s} < 0.92}$, we find the mean effective temperature of NOAA 7981 to be $\simeq$300 K less than the local photospheric temperature. Because the area is dominated by penumbral pixels, the temperature is close to a value representing the penumbra. Second, separating umbral and penumbral pixels, we obtain a temperature difference of $\simeq$850 K for the umbra and of $\simeq$200 K for the penumbra. Finally, if a 5% binning of the spot intensities is applied, a temperature deficit of $\simeq$1000 K is found for the darkest regions of the spot

Prevalence Martin-Gruberovy anastomózy – elektrofyziologie studie

Objective: Martin-Gruber anastomosis (MGA) is a median-to-ulnar nerve communication in the forearm; three types of MGA occur. Typically, motor fi bres course through the median nerve in the upper arm and elbow, however, they supply the ulnar-innervated muscles of the hand: abductor digiti minimi (ADM) – MGA-I; fi rst dorsal interosseous (FDI) – MGA-II; or adductor pollicis – MGA-III. The objective was to determine the prevalence of MGA in a study group of healthy volunteers. Methods: Two hundred and ninety-two healthy participants (457 arms) were enrolled. Motor and sensory nerve conduction studies of the ulnar and median nerves were performed. Ulnar and median nerve compound muscle action potential amplitudes were obtained on stimulation at the elbow and wrist. Results: We found 109 cases of MGA in 90 arms (MGA-I in 30 arms; MGA-II in 57 arms; MGA-III in 22 arms). We found isolated MGA types in 73 arms, a combination of two types in 15 arms, and occasionally (2 arms) a simultaneous combination of all three types. Conclusion: The prevalence of MGA was 19.7%. Most frequently, we found MGA-II (prevalence = 12.5%). Signifi cance: MGA does not produce any clinical signs. However, it can change EMG results. The neurophysiologist must be able to logically interpret such fi ndings.Úvod: Prevalence Martin-Gruberovy anastomózy (MGA), spojky n. medianus a ulnaris na předloktí se uvádí v rozmezí 15– 39 %. Existují tři různé typy MGA, kdy motorická vlákna jsou v oblasti paže a lokte vedena skrze n. medianus a zásobují svaly ruky inervované n. ulnaris (m. abductor digiti minimi, m. interosseus dorsalis primus či m. adductor pollicis). Soubor a metodika: V pěti EMG laboratořích bylo unifi kovanou technikou vyšetřeno 292 zdravých osob ve věku 20– 67 let, průměr 39,4 let: 166 žen (256 rukou) a 126 mužů (201 rukou), celkem 457 rukou. Byla provedena motorická a senzitivní neurografie n. ulnaris a n. medianus. Pro detekci MGA mělo zásadní význam hodnocení amplitudy CMAP pro n. ulnaris a n. medianus při stimulaci z oblasti lokte a zápěstí. Výsledky: V našem souboru 457 vyšetřených rukou jsme na 90 rukou našli 109 výskytů MGA. U 30 rukou se jednalo o MGA-I, u 57 rukou o MGA-II a u 22 rukou o MGA-III. Izolované typy MGA se vyskytly v 73 případech, Na 17 rukou se vyskytla kombinace dvou, ojediněle dokonce všech tří typů MGA současně. Závěr: V souboru 292 osob zdravých osob jsme na 457 hodnocených rukou našli MGA v 19,7 %. Nejčastěji se vyskytoval typ MGA-II (12,5 %)

Full-disk magnetic oscillations in the solar photosphere

Photospheric observations of the magnetic oscillations have been carried out to research magneto-acoustic waves in spots. The coupling between the magnetic field and the p-modes has been studied using reduced areas on the solar disk, but a global scenario is still missing. Four hour full-disk ma gne to grams (at 4 arcsec/pix spatial resolution) obtained in the sodium D-lines were analysed pixel-by-pixel (locally) and using the spherical harmonics decomposition (globally). Magnetic oscillations were detected at dif fe rent frequencies and identified on the solar disk. The global properties of the magnetic oscillations, shown via the $\ell -\nu$ diagrams, are for the first time presented and discussed