Quality of life after pulmonary embolism: validation of the French version of the PEmb-QoL questionnaire.

BackgroundThe PEmb-QoL is a validated 40-item questionnaire to quantify health-related quality of life in patients having experienced pulmonary embolism (PE). It covers six health dimensions: frequency of complaints, activities of daily living limitations, work-related problems, social limitations, intensity of complaints, and emotional complaints. Originally developed in Dutch and English, we sought to prospectively validate the psychometric properties of a French version of the PEmb-QoL.MethodsWe performed a forward and backward translation of the English version of the PEmb-QoL into French. French-speaking consecutive adult patients with an acute, objectively confirmed PE admitted to the emergency department of a Swiss university hospital between 08/2009 and 09/2011 were recruited telephonically. We used standard psychometric tests and criteria to evaluate the acceptability, reliability, and validity of the French version of the PEmb-QoL. We also performed an exploratory factor analysis.ResultsOverall, 102 patients were enrolled in the study. The French version of the PEmb-QoL showed good reliability (internal consistency, item¿total and inter-item correlations), reproducibility (test-retest reliability), and validity (convergent, discriminant) in French-speaking patients with PE. The exploratory factor analysis suggested three underlying dimensions: limitations in daily activity (items 4b-m, 5a-d), symptoms (items 1a-h and 7), and emotional complaints (items 9a-f and j).ConclusionWe successfully validated the French version of the PEmb-QoL questionnaire in patients with PE. Our results show that the PEmb-QoL is a valuable tool for assessing health-related quality of life after PE in French-speaking patients.

An fMRI-Study on context-specificity of inhibitory functions in alcohol-dependency: Preliminary results

Introduction: Alcohol-dependency is a common disease with many negative consequences in the daily life. A typical symptom of alcoholic-patients is the persistent and uncontrollable desire to consume alcohol. Inspite of different treatments, alcohol-dependency has a relapse rate of about 85%. This high rate is facilitated by a dysfunction of cognitive control-processes. In order to understand this disease sustaining factor, the present study investigated the neurophysiological correlates of inhibition of alcoholic-patients in a neutral as well as an alcohol-related context. Methods: A total of 18 participants, (9 alcohol-dependent-patients (age range: 27-62 years), 9 healthy controls (age range: 29-60 years)) have been measured with functional magnetic resonance imaging while they participated in an alcohol-specific Go/NoGo-Task. Neurophysiological correlates of inhibition in an alcohol-related as well as a neutral context were compared in both groups. Results: When comparing correct stop-trials in alcohol-related to neutral context, only alcohol-dependent patients showed significant hyperactivation in frontal regions (superior and medial gyrus frontalis, anterior gyrus cinguli, gyrus paracentralis and the gyrus praecentralis). No significant differences were found in any of the behavioral analyses. Discussion: These preliminary results thus indicate that successful inhibition in a drug-related context demands additional resources in patients. Especially the hyperactivation of the anterior gyrus cinguli might be important because of its involvement in decision-processes. In the absent of deficits in behavioral data, this suggests that alcohol-dependent patients need more neuronal activity to achieve the same performance-level like healthy controls.

Quality of life after pulmonary embolism: Prospective validation of the German version of the PEmb-QoL questionnaire.

BACKGROUND The Pulmonary Embolism Quality of Life questionnaire (PEmb-QoL) is a 40-item questionnaire to measure health-related quality of life in patients with pulmonary embolism. It covers six 6 dimensions: frequency of complaints, limitations in activities of daily living, work-related problems, social limitations, intensity of complaints, and emotional complaints. Originally developed in Dutch and English, we prospectively validated a German version of the PEmb-QoL. METHODS A forward-backward translation of the English version of the PEmb-QoL into German was performed. German-speaking consecutive adult patients aged ≥18 years with an acute, objectively confirmed pulmonary embolism discharged from a Swiss university hospital (01/2011-06/2013) were recruited telephonically. Established psychometric tests and criteria were used to evaluate the acceptability, reliability, and validity of the German PEmb-QoL questionnaire. To assess the underlying dimensions, an exploratory factor analysis was performed. RESULTS Overall, 102 patients were enrolled in the study. The German version of the PEmb-QoL showed a good internal consistency (Cronbach's alpha ranging from 0.72 to 0.96), item-total (0.53-0.95) and inter-item correlations (>0.4), and test-retest reliability (intra-class correlation coefficients 0.59-0.89) for the dimension scores. A moderate correlation of the PEmb-QoL with SF-36 dimension and summary scores (0.21-0.83) indicated convergent validity, while low correlations of PEmb-QoL dimensions with clinical characteristics (-0.16-0.37) supported discriminant validity. The exploratory factor analysis suggested four underlying dimensions: limitations in daily activities, symptoms, work-related problems, and emotional complaints. CONCLUSION The German version of the PEmb-QoL questionnaire is a valid and reliable disease-specific measure for quality of life in patients with pulmonary embolism.

A focused ethnographic study of women in recovery from alcohol abuse

Alcohol abuse and its related problems are among the most pervasive health and social concerns in the United States (U.S.) today. Women are especially vulnerable to the physical and social devastation of alcohol abuse. Yet, although there is extensive research about alcohol drinking patterns, treatment strategies, and early recovery, there is little information about the factors that facilitate successfully sustained abstinence in women. The purpose of this study was to examine and describe the common factors to successful recovery from alcohol abuse among women and to place these factors within both the context of their social networks and the larger social environment. This study draws from the population of New Mexico, where alcohol-related deaths are the highest of any state in the U.S. and the leading cause of death for individuals under the age of 65 years. The study was a focused ethnography of women who had successfully maintained long-term recovery from alcohol abuse. As an ethnographic study, data collection included participant observation, in-depth interviews with 21 women, and the collection of historical and current culturally relevant data. A purposive sampling plan was used to maximize the selection of participants who had used traditional and non-traditional approaches to recovery. As such, the analysis of the success narratives revealed two distinct findings: the first that women used several different trajectories to achieve long-term recovery. Three trajectory typologies were identified from the success narratives and labeled, A.A. as ceremony, A.A. as grounding, and Recovery as self-management. ^ However, within each of these trajectories, variations in successful recovery were seen. The second major finding was that all women articulated an overarching theme of connections as an indispensable aspect of sustained recovery. The success narratives demonstrated the powerful role that connections played in their long-term recovery and the analysis distinguished two unifying concepts of connections—those that focused beyond self (spirituality, social support, and pets) and those that focused toward self (self-nurturance, agency, and identity). This discussion will focus on the implications for clinical practice related to both women who are still actively abusing alcohol and for those who are successfully maintaining long-term recovery. ^

Prevalence and trends of substance abuse in Harris County, Texas, 1989 to 1991

In the late 1980s, Harris County, Texas began experiencing an escalation of drug-related activities. Various indicators used in this analysis tracked drug-related trends from 1989 to 1991 to determine patterns for comparison of local (Houston/Harris County, Texas) to national levels.^ An important indicator of the drug scenario was drug-related activities among youths, which increased during the period of this study. The Harris County Juvenile Probation Department showed that among arrests for drug-related activities, felonies increased from 25% in 1988 to 53% in 1991. With the rise in drug-related crimes, and substance abuse among the student body, school districts were forced to institute drug education programs in an effort to curtail such activities.^ Law enforcement agencies in the county saw increased demands for their services as a result of drug activities. Harris County Sheriffs Department reported a 32% plus increase in drug-related charges between 1986 and 1991. Houston Police Department reported an increase of 109% for the same period.^ Data from the Harris County Medical Examiner, the National Institute of Justice's Drug Use Forecasting System (Houston), and drug treatment facilities around Houston/Harris County, Texas indicated similar drug usage trends. Over a four-year period (1988-91), the drugs most frequently detected during blood and urine analyses were cocaine, followed by marijuana, heroin, LSD, and methamphetamines.^ From 1988 to 1991, most drug rehabilitation organizations experienced increased demands for their services by approximately 35%. Several other organizations experienced as much as a 70 percent increase. Males accounted for roughly 70% and females about 30% of persons seeking treatment. However, the number of females pursuing treatment increased, thereby reducing the gender gap.^ Blacks in Houston/Harris County were at higher risk for drug usage among the general population, but sought treatment more readily than other ethnic groups. Whites sought treatment in similar numbers as Blacks, but overall the risk appeared smaller because they made up a larger portion of the Houston/Harris County population.^ This analysis concluded that drug trends for the Houston/Harris County, Texas did not follow national trends, but showed patterns of its own. It was recommended that other communities carry out similar studies to determine drug use trends particular to their local. ^

BAYESIAN STATISTICAL METHODS IN GENE-ENVIRONMENT AND GENE-GENE INTERACTION STUDIES

Complex diseases such as cancer result from multiple genetic changes and environmental exposures. Due to the rapid development of genotyping and sequencing technologies, we are now able to more accurately assess causal effects of many genetic and environmental factors. Genome-wide association studies have been able to localize many causal genetic variants predisposing to certain diseases. However, these studies only explain a small portion of variations in the heritability of diseases. More advanced statistical models are urgently needed to identify and characterize some additional genetic and environmental factors and their interactions, which will enable us to better understand the causes of complex diseases. In the past decade, thanks to the increasing computational capabilities and novel statistical developments, Bayesian methods have been widely applied in the genetics/genomics researches and demonstrating superiority over some regular approaches in certain research areas. Gene-environment and gene-gene interaction studies are among the areas where Bayesian methods may fully exert its functionalities and advantages. This dissertation focuses on developing new Bayesian statistical methods for data analysis with complex gene-environment and gene-gene interactions, as well as extending some existing methods for gene-environment interactions to other related areas. It includes three sections: (1) Deriving the Bayesian variable selection framework for the hierarchical gene-environment and gene-gene interactions; (2) Developing the Bayesian Natural and Orthogonal Interaction (NOIA) models for gene-environment interactions; and (3) extending the applications of two Bayesian statistical methods which were developed for gene-environment interaction studies, to other related types of studies such as adaptive borrowing historical data. We propose a Bayesian hierarchical mixture model framework that allows us to investigate the genetic and environmental effects, gene by gene interactions (epistasis) and gene by environment interactions in the same model. It is well known that, in many practical situations, there exists a natural hierarchical structure between the main effects and interactions in the linear model. Here we propose a model that incorporates this hierarchical structure into the Bayesian mixture model, such that the irrelevant interaction effects can be removed more efficiently, resulting in more robust, parsimonious and powerful models. We evaluate both of the 'strong hierarchical' and 'weak hierarchical' models, which specify that both or one of the main effects between interacting factors must be present for the interactions to be included in the model. The extensive simulation results show that the proposed strong and weak hierarchical mixture models control the proportion of false positive discoveries and yield a powerful approach to identify the predisposing main effects and interactions in the studies with complex gene-environment and gene-gene interactions. We also compare these two models with the 'independent' model that does not impose this hierarchical constraint and observe their superior performances in most of the considered situations. The proposed models are implemented in the real data analysis of gene and environment interactions in the cases of lung cancer and cutaneous melanoma case-control studies. The Bayesian statistical models enjoy the properties of being allowed to incorporate useful prior information in the modeling process. Moreover, the Bayesian mixture model outperforms the multivariate logistic model in terms of the performances on the parameter estimation and variable selection in most cases. Our proposed models hold the hierarchical constraints, that further improve the Bayesian mixture model by reducing the proportion of false positive findings among the identified interactions and successfully identifying the reported associations. This is practically appealing for the study of investigating the causal factors from a moderate number of candidate genetic and environmental factors along with a relatively large number of interactions. The natural and orthogonal interaction (NOIA) models of genetic effects have previously been developed to provide an analysis framework, by which the estimates of effects for a quantitative trait are statistically orthogonal regardless of the existence of Hardy-Weinberg Equilibrium (HWE) within loci. Ma et al. (2012) recently developed a NOIA model for the gene-environment interaction studies and have shown the advantages of using the model for detecting the true main effects and interactions, compared with the usual functional model. In this project, we propose a novel Bayesian statistical model that combines the Bayesian hierarchical mixture model with the NOIA statistical model and the usual functional model. The proposed Bayesian NOIA model demonstrates more power at detecting the non-null effects with higher marginal posterior probabilities. Also, we review two Bayesian statistical models (Bayesian empirical shrinkage-type estimator and Bayesian model averaging), which were developed for the gene-environment interaction studies. Inspired by these Bayesian models, we develop two novel statistical methods that are able to handle the related problems such as borrowing data from historical studies. The proposed methods are analogous to the methods for the gene-environment interactions on behalf of the success on balancing the statistical efficiency and bias in a unified model. By extensive simulation studies, we compare the operating characteristics of the proposed models with the existing models including the hierarchical meta-analysis model. The results show that the proposed approaches adaptively borrow the historical data in a data-driven way. These novel models may have a broad range of statistical applications in both of genetic/genomic and clinical studies.

Text Comprehension And roduction in University Students: Text Reformulation

This paper sets out to report on findings about features of task-specific reformulation observed in university students in the middle stretch of the Psychology degree course (N=58) and in a reference group of students from the degree courses in Modern Languages, Spanish and Library Studies (N=33) from the National University of La Plata (Argentina). Three types of reformulation were modeled: summary reformulation, comprehensive and productive reformulation.The study was based on a corpus of 621 reformulations rendered from different kinds of text. The versions obtained were categorised according to the following criteria: presence or absence of normative, morphosyntactic and semantic difficulties. Findings show that problems arise particularly with paraphrase and summary writing. Observation showed difficulties concerning punctuation, text cohesion and coherence , and semantic distortion or omission as regards extracting and/or substituting gist, with limited lexical resources and confusion as to suitability of style/register in writing. The findings in this study match those of earlier, more comprehensive research on the issue and report on problems experienced by a significant number of university students when interacting with both academic texts and others of a general nature. Moreover, they led to questions, on the one hand, as to the nature of such difficulties, which appear to be production-related problems and indirectly account for inadequate text comprehension, and on the other hand, as to the features of university tuition when it comes to text handling.

Text Comprehension And roduction in University Students: Text Reformulation

This paper sets out to report on findings about features of task-specific reformulation observed in university students in the middle stretch of the Psychology degree course (N=58) and in a reference group of students from the degree courses in Modern Languages, Spanish and Library Studies (N=33) from the National University of La Plata (Argentina). Three types of reformulation were modeled: summary reformulation, comprehensive and productive reformulation.The study was based on a corpus of 621 reformulations rendered from different kinds of text. The versions obtained were categorised according to the following criteria: presence or absence of normative, morphosyntactic and semantic difficulties. Findings show that problems arise particularly with paraphrase and summary writing. Observation showed difficulties concerning punctuation, text cohesion and coherence , and semantic distortion or omission as regards extracting and/or substituting gist, with limited lexical resources and confusion as to suitability of style/register in writing. The findings in this study match those of earlier, more comprehensive research on the issue and report on problems experienced by a significant number of university students when interacting with both academic texts and others of a general nature. Moreover, they led to questions, on the one hand, as to the nature of such difficulties, which appear to be production-related problems and indirectly account for inadequate text comprehension, and on the other hand, as to the features of university tuition when it comes to text handling.

Text Comprehension And roduction in University Students: Text Reformulation

This paper sets out to report on findings about features of task-specific reformulation observed in university students in the middle stretch of the Psychology degree course (N=58) and in a reference group of students from the degree courses in Modern Languages, Spanish and Library Studies (N=33) from the National University of La Plata (Argentina). Three types of reformulation were modeled: summary reformulation, comprehensive and productive reformulation.The study was based on a corpus of 621 reformulations rendered from different kinds of text. The versions obtained were categorised according to the following criteria: presence or absence of normative, morphosyntactic and semantic difficulties. Findings show that problems arise particularly with paraphrase and summary writing. Observation showed difficulties concerning punctuation, text cohesion and coherence , and semantic distortion or omission as regards extracting and/or substituting gist, with limited lexical resources and confusion as to suitability of style/register in writing. The findings in this study match those of earlier, more comprehensive research on the issue and report on problems experienced by a significant number of university students when interacting with both academic texts and others of a general nature. Moreover, they led to questions, on the one hand, as to the nature of such difficulties, which appear to be production-related problems and indirectly account for inadequate text comprehension, and on the other hand, as to the features of university tuition when it comes to text handling.

Survey of living conditions of Arctic indigenous peoples

Major findings of the Survey of Living Conditions in the Arctic (SLiCA) are: (1) A combination of traditional activities and cash employment is the prevailing lifestyle of Arctic indigenous peoples; (2) family ties, social support of each other, and traditional activities have a lot to do with why indigenous people choose to remain in Arctic communities; (3) well-being is closely related to job opportunities, locally available fish and game, and a sense of local control. Well-being and depression (and related problems like suicide) are flip sides of the same coin. Improving well-being may reduce social problems; and, (4) health conditions vary widely in the Arctic: three-in-four Greenlandic Inuit self-rate their health as at least very good compared with one-in-two Canadian and Alaska Inuit and one-in-five Chukotka indigenous people. Findings are based on 7,200 interviews in a probability sample of Inupiat settlement regions of Alaska, the four Inuit settlement regions of Canada, all of Greenland, and the Anadyrskij, Anadyr, Shmidtovs, Beringovskij, Chukotskij, Iujl'tinskij, Bilibinskij, Chaunskij, Providenskij, Uel'Kal' districts of Chukotka. Indigenous people and researchers from Greenland, Russia, Canada, the United States, Denmark, Norway, Sweden, and Finland collaborated on all phases of the study.

The lead salt quantum dot intermediate band solar cell

We propose a new kind of quantum dot (QD) materials for the implementation of the intermediate band solar cell (IBSC) [1]. The materials are formed by lead salt QDs of the family IV-VI (PbTe, PbSe or PbS) embedded in a semiconductor of the family II-VI (Cd1-xMgxTe, CdxZn1-xTe, and CdS1-xSex or ZnSe1-xTex, respectively). These QDs are not nucleated due to lattice mismatch, as it is the case of the InAs/GaAs QD material system grown by the Stranski-Krastanov (S-K) mode. In these materials, the QDs precipitate due to the difference in lattice type: the QD lead salt material crystallizes in the rocksalt structure, while the II-VI host material has the zincblende structure [2]. Therefore, it is possible to use lattice-matched QD/host combinations, avoiding all the strain-related problems found in previous QD-IBSC developments. In this paper we discuss the properties of the lead salt QD materials and propose that they are appropriate to overcome the fundamental drawbacks of present III-V-based QD-IBSC prototypes. We also calculate the band diagram for some examples of IV-VI/II-VI QD materials. The detailed balance efficiency limit of QD-IBSCs based on the studied materials is found to be over 60% under maximum concentration.

Wireless Optical Communications for Intra-Spacecraft Networks Based on OCDMA with Random Optical Codes

In recent years, spacial agencies have shown a growing interest in optical wireless as an alternative to wired and radio-frequency communications. The use of these techniques for intra-spacecraft communications reduces the effect of take-off acceleration and vibrations on the systems by avoiding the need for rugged connectors and provides a significant mass reduction. Diffuse transmission also eases the design process as terminals can be placed almost anywhere without a tight planification to ensure the proper system behaviour. Previous studies have compared the performance of radio-frequency and infrared optical communications. In an intra-satellite environment optical techniques help reduce EMI related problems, and their main disadvantages - multipath dispersion and the need for line-of-sight - can be neglected due to the reduced cavity size. Channel studies demonstrate that the effect of the channel can be neglected in small environments if data bandwidth is lower than some hundreds of MHz.

Numerical simulation of tangling in jet engine turbines

The numerical analysis of certain safety related problems presents serious difficulties, since the large number of components present leads to huge finite elementmodels that can only be solved by using large and expensive computers or by making rough approaches to the problem. Tangling, or clashing, in the turbine of a jet engine airplane is an example of such problems. This is caused by the crash and friction between rotor and stator blades in the turbine after an eventual shaft failure. When facing the study of an event through numerical modelling, the accurate simulation of this problem would require the engineer to model all the rotor and stator blades existing in the turbine stage, using a small element size in all pieces. Given that the number of stator and rotor blades is usually around 200, such simulations would require millions of elements. This work presents a new numerical methodology, specifically developed for the accurate modelling of the tangling problem that, depending on the turbine configuration, is able to reduce the number of nodes up to an order of magnitude without losing accuracy. The methodology, which benefits from the cyclic configuration of turbines, is successfully applied to the numerical analysis of a hypothetical tangling event in a turbine, providing valuable data such as the rotating velocity decrease of the turbine, the braking torque and the damage suffered by the blades. The methodology is somewhat general and can be applied to any problem in which damage caused by the interaction between a rotating and static piece is to be analysed.

Don't blame the economists. It is an inverse problem!

The seriousness of the current crisis urgently demands new economic thinking that breaks the austerity vs. deficit spending circle in economic policy. The core tenet of the paper is that the most important problems that natural and social science are facing today are inverse problems, and that a new approach that goes beyond optimization is necessary. The approach presented here is radical in the sense that it identifies the roots in key assumptions in economic theory such as optimal behavior and stability to provide an inverse thinking perspective to economic modeling, of use in economic and financial stability policy. The inverse problem provides a truly multidisciplinary platform where related problems from different disciplines can be studied under a common approach with comparable results.

Aerodynamic study of a blended wing body, comparison with a conventional transport airplane.

Blended-wing-body (BWB) aircraft are being studied with interest and effort to improve economic efficiency and to overcome operational and infrastructure related problems associated to the increasing size of conventional transport airplanes. The objective of the research reported here is to assess the aerodynamic feasibility and operational efficiency of a great size, blended wing body layout, a configuration which has many advantages. To this end, the conceptual aerodynamic design process of an 800 seat BWB has been done completed with a comparison of performance and operational issues with last generation of conventional very large aircraft. The results are greatly encouraging and predict about 20 percent increase in transport productivity efficiency, without the burden of new or aggravated safety or operational problems.