Development of a value-based scoring system for the MobQoL-7D: a novel tool for measuring quality-adjusted life years in the context of mobility impairment

To create a preference-based value set scoring system for the MobQoL-7D outcome measure, and to examine differences in the health state preferences of the general population and individuals with impaired mobility. A preference elicitation study was undertaken to ascribe utility weights to all health states (i.e., all unique combination of answers) described by the MobQoL-7D. The elicitation exercise was developed using the Online Elicitation of Personal Utility Functions (OPUF) tool. Two UK sample groups were recruited; firstly a representative general population sample (N = 504), secondly a balanced sample of individuals with impaired mobility (N = 368). Distinct preference-based value sets were developed for each sample. Differences in dimension ranking, weighting, and overall utility values were assessed. The general population sample considered most health states, especially the more severe states, to be worse than the mobility impaired sample comparatively. Statistically significant differences between the samples were observed in four of the seven MobQoL-7D dimensions. This study is the first to provide preference-based value sets for the MobQoL-7D, ready for use in economic evaluations, QALY calculation, and other clinical or research applications. The study demonstrates how the general public and individuals with impaired mobility value health states differently. The MobQoL-7D offers a concise and valid tool for rehabilitation professionals to measure and monitor quality of life and quality-adjusted life years (QALYs) in the context of mobility impairment.The MobQoL-7D value set calculator allows summary utility scores and QALYs to be calculated using MobQoL-7D outcome data; the first of its kind.The general public and individuals with impaired mobility value health states differently, which could impact cost-per QALY calculations and subsequent service commissioning and funding decisions. The MobQoL-7D offers a concise and valid tool for rehabilitation professionals to measure and monitor quality of life and quality-adjusted life years (QALYs) in the context of mobility impairment. The MobQoL-7D value set calculator allows summary utility scores and QALYs to be calculated using MobQoL-7D outcome data; the first of its kind. The general public and individuals with impaired mobility value health states differently, which could impact cost-per QALY calculations and subsequent service commissioning and funding decisions.</p

Activation and Fluoride-Assisted Phosphating of Aluminum-Silicon-Coated Steel

Phosphating is a crucial process in the corrosion protection of metals. Here, activation and fluoride-assisted tricationic phosphating is investigated on aluminum–silicon (AS) coated steel surfaces. Dynamic light scattering results from the activation bath show a bimodal size distribution, with hydrodynamic radii of ∼400 nm and ∼10 μm. For the smaller particle fraction, static light scattering results are consistent with the interpretation of disklike particles as scattering objects. Particles of the larger fraction sediment with time. In the presence of electrolyte, the scattering intensity from the larger particle fraction increases. Coagulation with time is suggested to be related to the decrease in activity of the activation bath. Scanning Auger microscopy (SAM) shows a higher phosphorus concentration after titanium phosphate activation in the Al-rich areas compared to the Si-rich areas of the AS coatings. There is no correlation between the size of the species in the activation bath, and the size of the phosphate-containing regions on the activated surface. Phosphating was performed in the presence of hexafluorosilicic acid, H₂SiF₆, ammonium hydrogen difluoride, NH₄HF₂, and both, at an initial pH of 2.5. The absence of crystals after phosphating with H₂SiF₆ is an indication that SiF₆^2– is the final product of the oxide dissolution in the presence of fluoride. In the presence of NH₄HF₂, the Si-rich regions of the surface are phosphated before the Si-poor (Al-rich) regions. Hence, the phosphate distribution after activation and after phosphating are opposite. These results show that a high surface concentration of phosphate after activation is not sufficient for a high coverage with phosphate crystals after phosphating

Demographic and clinical characteristics of patients.

<p>PTH: parathyroid hormone, p-HPT: primary hyperparathyroidism, t-HPT: tertiary hyperparathyroidism</p><p>Normal range of values: PTH ≤ 70 ng/l, Calcium 2.09–2.54 mmol/l, Phosphate 0.87–1.45 mmol/l</p><p>Demographic and clinical characteristics of patients.</p

Contingency tables of patients with primary hyperparathyroidism.

<p>Pathology was counted as positive when a pathologic parathyroid was found at site of SPECT lesion</p><p>SPECT: single photon emission tomography, pos: positive, neg: negative.</p><p>Contingency tables of patients with primary hyperparathyroidism.</p

Example of dual-isotope ^99mTc-tetrofosmin and ¹²³I sodium iodide single-photon-emission-computed-tomography (SPECT).

<p>^<b>123</b>I sodium iodide image (middle panel) was semi-manually normalized to ^<b>99m</b>Tc-tetrofosmin image (upper panel) and afterwards subtracted from it (lower panel). Adenoma was detected at the right lower pole of the thyroid and patient received minimal invasive surgery (duration of surgery 90 minutes).</p

Differences in demographics, laboratory values, gland weight and duration of surgery in SPECT- positive and - negative p-HPT subjects in patient based analysis.

<p>PTH: parathyroid hormone</p><p>Normal range of values: PTH ≤ 70 ng/l, Calcium 2.09–2.54 mmol/l, Phosphate 0.87–1.45 mmol/l</p><p>Differences in demographics, laboratory values, gland weight and duration of surgery in SPECT- positive and - negative p-HPT subjects in patient based analysis.</p

Contingency tables of patiens with tertiary hyperparathyroidism.

<p>Pathology was counted as positive when a pathologic parathyroid was found at site of SPECT lesion</p><p>SPECT: single photon emission tomography, pos: positive, neg: negative.</p><p>Contingency tables of patiens with tertiary hyperparathyroidism.</p

<i>S</i>. <i>pneumoniae</i> serotypes differentially induce PLY- and caspase-1-dependent production of IL-1β by PBMCs as well as cell death.

<p>(A-C, H-L) PBMCs were infected with <i>S</i>. <i>pneumoniae</i> strains (MOI = 1) as indicated or (D, E) were infected with <i>S</i>. <i>pneumoniae</i> D39 (MOI = 0.01) and treated with 10 μM Z-YVAD. Production of IL-1β (A, D, H) and IL-8 (C, E, J) was quantified by ELISA after 16 h. (D, E) 100% were defined as the amount of IL-1β or IL-8 released by <i>S</i>. <i>pneumoniae</i>-infected PBMCs. (B, I) Relative expression of <i>Il1b</i> was determined by quantitative RT-PCR after 5 h. (F) Human blood was incubated with pneumococcal lysates of <i>S</i>. <i>pneumoniae</i> serotypes 3, 6B, 7F, 9N, 1 and 8, and haemolytic activity was assessed. (G) Comparative protein model of allele 5 PLY. PLY domains are colour coded and mutations are marked in rose. (K) PBMCs were infected with <i>S</i>. <i>pneumoniae</i> D39 and D39Δ<i>ply</i>. (L) PBMCs were infected with serotypes 3, 6B, 7F, 9N, 1 and 8 pneumococci. (M) PBMCs were stimulated with allele 1 and allele 5 PLY for 16 h. (K-M) LDH release was quantified by cytotoxicity assay. Data are shown as mean ± SEM of three (D, E, M), five (B, I) or seven (A, C, H, J, K, L) independent experiments carried out in duplicates or triplicates. Significance is indicated by asterisks * = p<0.05, ** = p<0.01, *** = p<0.001.</p

The production of IL-1β in <i>S</i>. <i>pneumoniae</i>-infected human lung tissue is dependent on PLY and caspase-1.

<p>(A-E) Human lung tissue was infected with 1x10⁶ CFU/mL <i>S</i>. <i>pneumoniae</i> serotype 2 D39 or D39Δ<i>ply</i> and treated with 100 ng/ml Z-YVAD 1 hour before infection where indicated. After 24 h, production of IL-1β (A, B, E) was quantified by ELISA, relative expression of <i>Il1b</i> was determined by qRT-PCR (C), or expression of pro-IL-1β was assessed by immunoblotting (D). Data are shown as mean ± SEM of three (A), five (E) or six (B, C) independent experiments carried out in duplicates. (D) One representative of four independent experiments is shown. Significance is indicated by asterisks ** = p<0.01, *** = p<0.001.</p

Pneumolysin allele determination by sequencing of <i>ply</i> genes was performed from the 6 isolates used in this study.

<p>The first row refers to amino acid positions. The second row shows allele 1 PLY expressed in <i>S</i>. <i>pneumoniae</i> D39 [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0137108#pone.0137108.ref021" target="_blank">21</a>]. The amino acid polymorphisms in the clinical isolates are highlighted. Deletion of an amino acid is represented by the abbreviation DEL. Serotype 1 and 8 pneumococci express an allele 5 PLY as previously shown [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0137108#pone.0137108.ref021" target="_blank">21</a>].</p