EQ-5D in skin conditions: an assessment of validity and responsiveness

Aims and objectives This systematic literature review aims to assess the reliability, validity and responsiveness of three widely used generic preference-based measures of health-related quality of life (HRQL), i.e., EQ-5D, Health Utility Index 3 (HUI3) and SF-6D in patients with skin conditions. Methods A systematic search was conducted to identify studies reporting health state utility values obtained using EQ-5D, SF-6D, or HUI3 alongside other HRQL measures or clinical indices for patients with skin conditions. Data on test-retest analysis for reliability, known group differences or correlation and regression analyses for validity, and change over time or responsiveness indices analysis were extracted and reviewed. Results A total of 16 papers reporting EQ-5D utilities in people with skin conditions were included in the final review. No papers for SF-6D and HUI3 were found. Evidence of reliability was not found for any of these measures. The majority of studies included in the review (12 out of 16) examined patients with plaque psoriasis or psoriatic arthritis and the remaining four studies examined patients with either acne, hidradenitis suppurativa, hand eczema, or venous leg ulcers. The findings were generally positive in terms of performance of EQ-5D. Six studies showed that EQ-5D was able to reflect differences between severity groups and only one reported differences that were not statistically significant. Four studies found that EQ-5D detected differences between patients and the general population, and differences were statistically different for three of them. Further, moderate-to-strong correlation coefficients were found between EQ-5D and other skin-specific HRQL measures in four studies. Eight studies showed that EQ-5D was able to detect change in HRQL appropriately over time and the changes were statistically significant in seven studies. Conclusions Overall, the validity and responsiveness of the EQ-5D was found to be good in people with skin diseases, especially plaque psoriasis or psoriatic arthritis. No evidence on SF-6D and HUI3 was available to enable any judgments to be made on their performance

A study of geographical distribution of geomagnetic micropulsations Final report

Geographical distributions of geomagnetic micropulsations continuously recorded on frequency modulated magnetic tap

Chandra observations of the pulsar wind nebula in SNR G0.9+0.1

We present observations with the Chandra X-ray Observatory of the pulsar wind nebula (PWN) within the supernova remnant G0.9+0.1. At Chandra's high resolution, the PWN has a clear axial symmetry; a faint X-ray point source lying along the symmetry axis possibly corresponds to the pulsar itself. We argue that the nebular morphology can be explained in terms of a torus of emission in the pulsar's equatorial plane and a jet directed along the pulsar spin axis, as is seen in the X-ray nebulae powered by other young pulsars. A bright clump of emission within the PWN breaks the axisymmetry and may correspond to an intermediate-latitude feature in the pulsar wind.Comment: 5 pages, 2 embedded EPS figures, uses emulateapj.sty . Accepted to ApJ Letter

The effect of drought on dissolved organic carbon (DOC) release from peatland soil and vegetation sources

Drought conditions are expected to increase in frequency and severity as the climate changes, representing a threat to carbon sequestered in peat soils. Downstream water treatment works are also at risk of regulatory compliance failures and higher treatment costs due to the increase in riverine dissolved organic carbon (DOC) often observed after droughts. More frequent droughts may also shift dominant vegetation in peatlands from Sphagnum moss to more drought tolerant species. This paper examines the impact of drought on the production and treatability of DOC from four vegetation litters (Calluna vulgaris, Juncus effusus, Molinia caerulea and Sphagnum spp.) and a peat soil. We found that mild droughts caused a 39.6 % increase in DOC production from peat and that this DOC was harder to remove by conventional water treatment processes (coagulation/flocculation). Drought had no effect on DOC production from vegetation litters, however large variation was observed between typical peatland species (Sphagnum and Calluna) and drought tolerant grassland species (Juncus and Molinia), with the latter producing more DOC per unit weight. This would therefore suggest the increase in riverine DOC often observed post-drought is due entirely to soil microbial processes and DOC solubility rather than litter-layer effects. Long term shifts in species diversity may, therefore, be the most important impact of drought on litter layer DOC flux, whereas more immediate effects are observed in peat soils. These results provide evidence in support of catchment management which increases the resilience of peat soils to drought, such as ditch-blocking to raise water-tables

Assessing the impact of peat erosion on growing season CO2 fluxes by comparing erosional peat pans and surrounding vegetated haggs (article)

This is the author accepted manuscript. The final version is available from International Mire Conservation Group and International Peat Society via the DOI in this record.The research data supporting this publication are openly available from the University of Exeter's institutional repository at: https://doi.org/10.24378/exe.1143.Peatlands are recognised as an important but vulnerable ecological resource. Understanding the effects of existing damage, in this case erosion, enables more informed land management decisions to be made. Over the growing seasons of 2013 and 2014 photosynthesis and ecosystem respiration were measured using closed chamber techniques within vegetated haggs and erosional peat pans in Dartmoor National Park, southwest England. Below-ground total and heterotrophic respiration were measured and autotrophic respiration estimated from the vegetated haggs. The mean water table was significantly higher in the peat pans than in the vegetated haggs; because of this, and the switching from submerged to dry peat, there were differences in vegetation composition, photosynthesis and ecosystem respiration. In the peat pans photosynthetic CO2 uptake and ecosystem respiration were greater than in the vegetated haggs and strongly dependent on the depth to water table (r2>0.78, p<0.001). Whilst in the vegetated haggs, photosynthesis and ecosystem respiration had the strongest relationships with normalised difference vegetation index (NDVI) (r2=0.82, p<0.001) and soil temperature at 15 cm depth (r2=0.77, p=0.001). Autotrophic and total below-ground respiration in the vegetated haggs varied with soil temperature; heterotrophic respiration increased as water tables fell. An empirically derived net ecosystem model estimated that over the two growing seasons both the vegetated haggs (29 and 20 gC m 2; 95 % confidence intervals of -570 to 762 and -873 to 1105 gC m-2) and the peat pans (7 and 8 gC m 2; 95 % confidence intervals of -147 to 465 and -136 to 436 gC m 2) were most likely net CO2 sources. This study suggests that not only the visibly degraded bare peat pans but also the surrounding vegetated haggs are losing carbon to the atmosphere, particularly during warmer and drier conditions, highlighting a need for ecohydrological restoration.MomentaSouth West Water (SWW)Dartmoor National Park Authorit

Polarization Observations of 1720 MHz OH Masers toward the Three Supernova Remnants W28, W44, and IC443

(abridged) - We present arcsecond resolution observations from the VLA of the satellite line of the hydroxyl molecule (OH) at 1720.53 MHz toward three Galactic supernova remnants: W28, W44 and IC443. All of our observations are consistent with a model in which the OH(1720 MHz) is collisionally excited by H2 molecules in the postshock gas heated by a non-dissociative shock. Supernova remnants with OH(1720 MHz) maser emission may be promising candidates to conduct high energy searches for the sites of cosmic ray acceleration.Comment: ApJ Let (accepted). Hardcopies available from [email protected]

Condition-specific or generic preference-based measures in oncology? A comparison of the EORTC-8D and the EQ-5D-3L.

PURPOSE: It has been argued that generic health-related quality of life measures are not sensitive to certain disease-specific improvements; condition-specific preference-based measures may offer a better alternative. This paper assesses the validity, responsiveness and sensitivity of a cancer-specific preference-based measure, the EORTC-8D, relative to the EQ-5D-3L. METHODS: A longitudinal prospective population-based cancer genomic cohort, Cancer 2015, was utilised in the analysis. EQ-5D-3L and the EORTC QLQ-C30 (which gives EORTC-8D values) were asked at baseline (diagnosis) and at various follow-up points (3 months, 6 months, 12 months). Baseline values were assessed for convergent validity, ceiling effects, agreement and sensitivity. Quality-adjusted life-years (QALYs) were estimated and similarly assessed. Multivariate regression analyses were employed to understand the determinants of the difference in QALYs. RESULTS: Complete case analysis of 1678 patients found that the EQ-5D-3L values at baseline were significantly lower than the EORTC-8D values (0.748 vs 0.829, p < 0.001). While the correlation between the instruments was high, agreement between the instruments was poor. The baseline health state values using both instruments were found to be sensitive to a number of patient and disease characteristics, and discrimination between disease states was found to be similar. Mean generic QALYs (estimated using the EQ-5D-3L) were significantly lower than condition-specific QALYs (estimated using the EORTC-8D) (0.860 vs 0.909, p < 0.001). The discriminatory power of both QALYs was similar. CONCLUSIONS: When comparing a generic and condition-specific preference-based instrument, divergences are apparent in both baseline health state values and in the estimated QALYs over time for cancer patients. The variability in sensitivity between the baseline values and the QALY estimations means researchers and decision makers are advised to be cautious if using the instruments interchangeably

A survey of agent-oriented methodologies

This article introduces the current agent-oriented methodologies. It discusses what approaches have been followed (mainly extending existing object oriented and knowledge engineering methodologies), the suitability of these approaches for agent modelling, and some conclusions drawn from the survey

Sensitivity of peatland litter decomposition to changes in temperature and rainfall

Changes to climate are projected over the next 50 years for many peatland areas. As decomposition of peatforming vegetation is likely to be intrinsically linked to these changes in climate, a clear understanding of climate-peat dynamics is required. There is concern that increased temperature and decreased precipitation could increase the rate of decomposition and put the carbon sink status of many peatlands at risk, yet few studies have examined the impact of both climatic factors together. To better understand the sensitivity of peatland decomposition to changes in both temperature and precipitation and their interaction, we conducted a shortterm laboratory experiment in which plant litters and peat soil were incubated, in isolation, in a factorial design. Treatments simulated baseline and projected climate averages derived from the latest UK climate change projections (UKCP09) for Exmoor, a climatically marginal peatland in SW England. Regular carbon dioxide flux measurements were made throughout the simulation, as well as total mass loss and total dissolved organic carbon (DOC) leached. The largest effect on carbon loss in this multifactor experiment was from substrate, with Sphagnum/peat releasing significantly less C in total during the experiment than dwarf shrubs/graminoids. Climate effects were substrate specific, with the drier rainfall treatment increasing the DOC leaching from Calluna, but decreasing it from Sphagnum. Partitioning between CO2 and DOC was also affected by climate, but only for the peat and Sphagnum samples, where the future climate scenarios (warmer and drier) resulted in a greater proportion of C lost in gaseous form. These results suggest that indirect effects of climate through changes in species composition in peatlands could ultimately turn out to be more important for litter decomposition than direct effects of climate change from increased temperatures and decreased rainfall

Australian utility weights for the EORTC QLU-C10D, a multi-attribute utility instrument derived from the cancer-specific quality of life questionnaire, EORTC QLQ-C30

Background: The EORTC QLU-C10D is a new multi-attribute utility instrument derived from the widely-used cancer-specific quality of life questionnaire, EORTC QLQ-C30. The QLU-C10D contains ten dimensions (Physical, Role, Social and Emotional Functioning; Pain, Fatigue, Sleep, Appetite, Nausea, Bowel Problems), each with 4 levels. To be used in cost-utility analysis, country-specific valuation sets are required. Objective: To provide Australian utility weights for the QLU-C10D. Methods: An Australian online panel was quota sampled to ensure population representativeness by sex and age (≥18y). Participants completed a discrete choice experiment (DCE) consisting of 16 choice-pairs. Each pair comprised two QLU-C10D health states plus life expectancy. Data were analysed using conditional logistic regression, parameterised to fit the quality-adjusted life-year framework. Utility weights were calculated as the ratio of each QOL dimension-level coefficient to the coefficient on life expectancy. Results: 1979 panel members opted-in, 1904 (96%) completed at least one choice-pair, and 1846 (93%) completed all 16 choice-pairs. Dimension weights were generally monotonic: poorer levels within each dimension were generally associated with greater utility decrements. The dimensions that impacted most on choice were, in order, Physical Functioning, Pain, Role Functioning and Emotional Functioning. Oncology-relevant dimensions with moderate impact were Nausea and Bowel Problems. Fatigue, Trouble Sleeping and Appetite had relatively small impact. The value of the worst health state was -0.096, somewhat worse than death. Conclusions: This study provides the first country-specific value set for the QLU-C10D, which can facilitate cost-utility analyses when applied to data collected with the EORTC QLQ-C30, prospectively and retrospectively