Patients' self-assessed functional status in heart failure by New York Heart Association class: a prognostic predictor of hospitalizations, quality of life and death.

BACKGROUND: Clinician-assigned New York Heart Association (NYHA) class is an established predictor of outcomes in heart failure. This study aims to test whether patients' self-assessment of functional status by NYHA class predicts hospital admissions, quality of life, and mortality. METHODS AND RESULTS: This was an observational study within a randomized controlled trial. A total of 293 adult patients diagnosed with heart failure were recruited after an emergency admission at 3 acute hospitals in Norfolk, UK. Outcome measures included number of emergency admissions over 6 months, self-assessed quality of life measured with the Minnesota Living with Heart Failure questionnaire (MLHFQ) and EQ-5D at 6 months, and deaths up to 20 months' follow-up. Patients were grouped into 3 NYHA groups (I/II, III, and IV) based on patients' self-assigned NYHA class (SA-NYHA). A Poisson model indicated an increased readmission rate associated with higher SA-NYHA class (adjusted rate ratio 1.21; 95% CI 1.04-1.41; P=.02). Higher SA-NYHA class at baseline predicted worse quality of life at 6 months' follow-up (P=.002 for MLHFQ; P=.047 for EQ-5D), and was associated with higher mortality rate (adjusted hazard ratio 1.84; 95% CI 1.10-3.06; P=.02). CONCLUSIONS: SA-NYHA class is predictive of hospitalization, quality of life, and mortality among patients with heart failure

Antioxidant requirements of rats exposed to 100 % oxygen. Part 2 - Effects of dietary ascorbic acid

Dietary ascorbic acid effects as antioxidants in rats exposed to 100 percent oxyge

Prototyping of the ILC Baseline Positron Target

The ILC positron system uses novel helical undulators to create a powerful photon beam from the main electron beam. This beam is passed through a titanium target to convert it into electron-positron pairs. The target is constructed as a 1 m diameter wheel spinning at 2000 RPM to smear the 1 ms ILC pulse train over 10 cm. A pulsed flux concentrating magnet is used to increase the positron capture efficiency. It is cooled to liquid nitrogen temperatures to maximize the flatness of the magnetic field over the 1 ms ILC pulse train. We report on prototyping effort on this system.Comment: 7 pages, 9 figures, Proceedings of the International Workshop on Future Linear Colliders, Granada Spain, 26-30 September 201

The Solitary Place Shall Be Glad for Them: Understanding and Treating Mormon Pioneer Gardens as Cultural Landscapes

The gardens of early Mormon pioneers are a unique cultural resource in the western United States, but little guidance has been provided for understanding or providing landscape treatments for Mormon landscapes. Mormon pioneers came to Utah and the Great Basin to escape religious persecution and build their own holy kingdom. In relative geographical isolation, they built towns that have a distinctive character delineating a Mormon cultural region in the West. Self-sufficiency was an important feature of these towns and of the religious culture of early Mormons, both because of their geographical isolation and their desire to be independent of the world, which they viewed as wicked. This emphasis on self-sufficiency made gardens and gardening an important part of every household, encouraged by religious leaders and individual need. The cultural and personal preferences of individuals did influence the style and contents of Mormon pioneer gardens, but perhaps not to the extent that the religious culture of self-sufficiency did. When managing or treating Mormon pioneer landscapes or gardens, it is helpful to start by assessing any historic features that still exist. Then, the property owner or manager can choose one of the standard landscape treatments of preservation, rehabilitation, restoration, or reconstruction, or opt for some combination of these treatments. Because Mormon pioneers brought plants from all over the world, a large selection of heirloom plants may be suitable for historic Mormon landscapes. A few historic plants are no longer appropriate in Western landscapes because of ecological concerns such as invasiveness or water efficiency, but substitutions for these plants can be found by considering the plant\u27s form, function, and meaning in the historic landscape

Blood changes in acutely splenectomized rats during prolonged hyperoxic exposure

Effect of high pressure oxygen exposure on red blood cells in splenectomized rat

Direct health costs of inflammatory polyarthritis 10 years after disease onset:Results from the Norfolk Arthritis Register

Objectives: To explore the change in direct medical costs associated with inflammatory polyarthritis (IP) 10 to 15 years after its onset. Methods: Patients from the Norfolk Arthritis Register who had previously participated in a health economic study in 1999 were traced 10 years later and invited to participate in a further prospective questionnaire-based study. The study was designed to identify direct medical costs and changes in health status over a 6-month period using previously validated questionnaires as the primary source of data. Results: A representative sample of 101 patients with IP from the 1999 cohort provided complete data over the 6-month period. The mean disease duration was 14 years (SD 2.1, median 13.6, interquartile range 12.6–15.4). The mean direct medical cost per patient over the 6-month period was £1496 for IP (inflated for 2013 prices). This compared with £582 (95% CI £355–£964) inflated to 2013 prices per patient with IP 10 years earlier in their disease. The increased cost was largely associated with the use of biologics in the rheumatoid arthritis subgroup of patients (51% of total costs incurred). Other direct cost components included primary care costs (11%), hospital outpatient (19%), day care (12%), and inpatient stay (4%). Conclusion: The direct healthcare costs associated with IP have more than doubled with increasing disease duration, largely as a result of the use of biologics. The results showed a shift in the direct health costs from inpatient to outpatient service use

Boron-Doped Diamond Dual-Plate Deep-Microtrench Device for Generator-Collector Sulfide Sensing

This is the author accepted manuscript. The final version is available from Wiley via the DOI in this record.A BDD-BDD dual-plate microtrench electrode with 6μm inter-electrode spacing is investigated using generator-collector electrochemistry and shown to give microtrench depth-dependent sulfide detection down to the μM levels. The effect of the microtrench depth is compared for a "shallow" 44 μm and a "deep" 180μm microtrench and linked to the reduction of oxygen to hydrogen peroxide which interferes with sulfide redox cycling. With a deeper microtrench and a fixed collector potential at -1.4V vs. SCE, two distinct redox cycling potential domains are observed at 0.0V vs. SCE (2-electron) and at 1.1V vs. SCE (6-electron).F. M. and A. J. G. thank EPSRC for financial support (EP/I028706/1)

Near-Infrared Characterization of Breast Tumors In Vivo using Spectrally-Constrained Reconstruction

Multi-wavelength Near-Infrared (NIR) Tomography was utilized in this study to non-invasively quantify physiological parameters of breast tumors using direct spectral reconstruction. Frequency domain NIR measurements were incorporated with a new spectrally constrained direct chromophore and scattering image reconstruction algorithm, which was validated in simulations and experimental phantoms. Images of total hemoglobin, oxygen saturation, water, and scatter parameters were obtained with higher accuracy than previously reported. Using this spectral approach, in vivo NIR images are presented and interpreted through a series of case studies (n=6 subjects) having differing abnormalities. The corresponding mammograms and ultrasound images are also evaluated. Three of six cases were malignant (infiltrating ductal carcinomas) and showed higher hemoglobin (34–86% increase), a reduction in oxygen saturation, an increase in water content as well as scatter changes relative to surrounding normal tissue. Three of six cases were benign, two of which were diagnosed with fibrocystic disease and showed a dominant contrast in water, consistent with fluid filled cysts. Scatter amplitude was the main source of contrast in the volunteer with the benign condition fibrosis, which typically contains denser collagen tissue. The changes monitored correspond to physiological changes associated with angiogenesis, hypoxia and cell proliferation anticipated in cancers. These changes represent potential diagnostic indicators, which can be assessed to characterize breast tumors