+Psychometric evaluation of the MacDQoL individualised measure of the impact of macular degeneration on quality of life

Background: The MacDQoL is an individualised measure of the impact of macular degeneration (MD) on quality of life (QoL). There is preliminary evidence of its psychometric properties and sensitivity to severity of MD. The aim of this study was to carry out further psychometric evaluation with a larger sample and investigate the measure's sensitivity to MD severity. Methods: Patients with MD (n = 156: 99 women, 57 men, mean age 79 ± 13 years), recruited from eye clinics (one NHS, one private) completed the MacDQoL by telephone interview and later underwent a clinic vision assessment including near and distance visual acuity (VA), comfortable near VA, contrast sensitivity, colour recognition, recovery from glare and presence or absence of distortion or scotoma in the central 10° of the visual field. Results: The completion rate for the MacDQoL items was 99.8%. Of the 26 items, three were dropped from the measure due to redundancy. A fourth was retained in the questionnaire but excluded when computing the scale score. Principal components analysis and Cronbach's alpha (0.944) supported combining the remaining 22 items in a single scale. Lower MacDQoL scores, indicating more negative impact of MD on QoL, were associated with poorer distance VA (better eye r = -0.431 p < 0.001; worse eye r = -0.350 p < 0.001; binocular vision r = -0.419 p < 0.001) and near VA (better eye r -0.326 p < 0.001; worse eye r = -0.226 p < 0.001; binocular vision r = -0.326 p < 0.001). Poorer MacDQoL scores were associated with poorer contrast sensitivity (better eye r = 0.392 p < 0.001; binocular vision r = 0.423 p < 0.001), poorer colour recognition (r = 0.417 p < 0.001) and poorer comfortable near VA (r = -0.283, p < 0.001). The MacDQoL differentiated between those with and without binocular scotoma (U = 1244 p < 0.001). Conclusion: The MacDQoL 22-item scale has excellent internal consistency reliability and a single-factor structure. The measure is acceptable to respondents and the generic QoL item, MD-specific QoL item and average weighted impact score are related to several measures of vision. The MacDQoL demonstrates that MD has considerable negative impact on many aspects of QoL, particularly independence, leisure activities, dealing with personal affairs and mobility. The measure may be valuable for use in clinical trials and routine clinical care. © 2005 Mitchell et al; licensee BioMed Central Ltd.

Regulation of beta-cell viability and gene expression by distinct agonist fragments of adiponectin

Obesity is an established risk factor for type 2 diabetes. Activation of the adiponectin receptors has a clear role in improving insulin resistance although conflicting evidence exists for its effects on pancreatic beta-cells. Previous reports have identified both adiponectin receptors (ADR-1 and ADR-2) in the beta-cell. Recent evidence has suggested that two distinct regions of the adiponectin molecule, the globular domain and a small N-terminal region, have agonist properties. This study investigates the effects of two agonist regions of adiponectin on insulin secretion, gene expression, cell viability and cell signalling in the rat beta-cell line BRIN-BD11, as well as investigating the expression levels of adiponectin receptors (ADRs) in these cells. Cells were treated with globular adiponectin and adiponectin (15-36) +/-leptin to investigate cell viability, expression of key beta-cell genes and ERK1/2 activation. Both globular adiponectin and adiponectin (15-36) caused significant ERK1/2 dependent increases in cell viability. Leptin co-incubation attenuated adiponectin (15-36) but not globular adiponectin induced cell viability. Globular adiponectin, but not adiponectin (15-36), caused a significant 450% increase in PDX-1 expression and a 45% decrease in LPL expression. ADR-1 was expressed at a higher level than ADR-2, and ADR mRNA levels were differentially regulated by non-esterified fatty acids and peroxisome-proliferator-activated receptor agonists. These data provide evidence of roles for two distinct adiponectin agonist domains in the beta-cell and confirm the potentially important role of adiponectin receptor agonism in maintaining beta-cell mass.

Effect of medications with anti-cholinergic properties on cognitive function, delirium, physical function and mortality:a systematic review

Objectives: to determine the effect of drugs with anti-cholinergic properties on relevant health outcomes.Design: electronic published and unpublished literature/trial registries were systematically reviewed. Studies evaluating medications with anti-cholinergic activity on cognitive function, delirium, physical function or mortality were eligible.Results: forty-six studies including 60,944 participants were included. Seventy-seven percent of included studies evaluating cognitive function (n = 33) reported a significant decline in cognitive ability with increasing anti-cholinergic load (P < 0.05). Four of five included studies reported no association with delirium and increasing anti-cholinergic drug load (P > 0.05). Five of the eight included studies reported a decline in physical function in users of anti-cholinergics (P < 0.05). Three of nine studies evaluating mortality reported that the use of drugs with anti-cholinergic properties was associated with a trend towards increased mortality, but this was not statistically significant. The methodological quality of the evidence-base ranged from poor to very good.Conclusion: medicines with anti-cholinergic properties have a significant adverse effect on cognitive and physical function, but limited evidence exists for delirium or mortality outcomes. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.

A Real-time Decision Support System Prototype for Management of a Power Block

This paper describes the basic tools for a real-time decision support system of a semiotic type on the example of the prototype for management and monitoring of a nuclear power block implemented on the basis of the tool complex G2+GDA using cognitive graphics and parallel processing. This work was supported by RFBR (project 02-07-90042).

A vállalati likviditásmenedzsment számviteli támogatása (Accounting support for company’s liquidity management)

A cikk kiindulópontja, hogy a kettős könyvvitelt vezető vállalkozások által kötelezően elkészítendő éves pénzügyi kimutatások (számviteli beszámolók) olyan információbázist jelentenek, amelyek segítséget nyújthatnak egyrészről a vállalati likviditásmenedzsment támogatásához, másrészről a vállalkozások likviditási helyzetének megítéléséhez. A cikk első fele felvázolja a vállalkozások pénzügyi helyzetét bemutató adatok számviteli kereteit, bemutatja a likviditás fogalmának egyes értelmezéseit, majd részletesen kitér arra, hogy a likviditás utólagos vizsgálatához, illetve előrejelzéséhez milyen korrekciókat kell (lehet) végezni a számviteli beszámoló adatain. A cikk második fele az elemzés lehetséges módjait és eszközeit veszi számba, kitérve a statikus és dinamikus elemzés közötti különbségek bemutatására, az egyes mutatók számításának lehetséges módjaira és értelmezésükre, mindvégig szem előtt tartva az alkalmazás korlátait. ________ The study examines how information provided by accounting information systems could support companies’ liquidity management. The starting point is that compulsory financial statements prepared by economic entities embody an adequate information basis, which could help liquidity management as well as the judgement of liquidity. The first part of the study introduces the various interpretations of liquidity and gives a detailed description of the adjustments that need to be made on accounting data for an a posteriori examination of liquidity and to be able to forecast liquidity. The second part discusses the possible means and tools of analysis, including the differences between static and dynamic methods and the calculation and interpretation of the various ratios widely used by professionals. The conclusion is that there is no best-practice method or ratio, but rather a wide range of tools is to be used when one is willing to gain a complex and comprehensive insight about an entity’s liquidity.

Vertical profiles of environmental parameters measured from physical, optical and imaging sensors during station TARA_032 of the Tara Oceans expedition 2009-2013

The Tara Oceans Expedition (2009-2013) sampled the world oceans on board a 36 m long schooner, collecting environmental data and organisms from viruses to planktonic metazoans for later analyses using modern sequencing and state-of-the-art imaging technologies. Tara Oceans Data are particularly suited to study the genetic, morphological and functional diversity of plankton. The present data set includes properties of seawater, particulate matter and dissolved matter from physical, optical and imaging sensors mounted on a vertical sampling system (Rosette) used during the 2009-2013 tara Oceans Expedition. It comprised 2 pairs of conductivity and temperature sensors (SEABIRD components), and a complete set of WEtLabs optical sensors, including chrorophyll and CDOM fluorometers, a 25 cm transmissiometer, and a one-wavelength backscatter meter. In addition, a SATLANTIC ISUS nitrate sensor and a Hydroptic Underwater Vision Profiler (UVP) were mounted on the rosette. In the Arctic Ocean and Arctic Seas (2013), a second oxygen sensor (SBE43) and a four frequency Aquascat acoustic profiler were added. The system was powered on specific Li-Ion batteries and data were self-recorded at 24HZ. Sensors have all been factory calibrated before, during and after the four year program. Oxygen was validated using climatologies (WOA09). Nitrate and Fluorescence data were adjusted with discrete measurements from Niskin bottles mounted on the Rosette, and optical darks were performed monthly on board. A total of 839 quality checked vertical profiles were made during the tara Oceans expedition 2009-2013.

Mineralogy of sea-floor surface sediments, Sonne cruise SO202/1 to the North Pacific and Bering Sea

During expedition 202 of research vessel SONNE in 2009, 39 sea-floor surface sediments were sampled over a wide area across the North Pacific and the Bering Sea, which are well suited as reference archives of modern environmental processes. In this study, we used the samples to infer the documentation of land-ocean linkages of terrigenous sediment supply. We followed an integrated approach of grain-size analysis, bulk mineralogy, and clay mineralogy in combination with statistical data evaluation (end-member modelling of grain-size data, fuzzy-cluster analysis of mineralogical data), in order to identify the significant sources and modes of sediment transport in an overregional context. We also compiled literature data on clay mineralogy and updated those with the new data. Today, two processes of terrigenous sediment supply prevail in the study area: far-distant aeolian sediment supply to the pelagic North Pacific as well as hemipelagic sediment dispersal from nearby land sources by ocean currents along the continental margins and island arcs of the study area. The aeolian particles show the finest grain sizes (clay and fine silt), while the hemipelagic sediments have high abundances of sortable silt, particles >10 microns.

Bioenergy and climate change mitigation : an assessment

Date of Acceptance: 08/05/2014 Acknowledgements The authors are indebted to Julia Römer for assisting with editing several hundred references. Helmut Haberl gratefully acknowledges funding by the Austrian Academy of Sciences (Global Change Programme), the Austrian Ministry of Science and Research (BMWF, proVision programme) as well as by the EU-FP7 project VOLANTE. Carmenza Robledo-Abad received financial support from the Swiss State Secretariat for Economic Affairs.

Bioenergy and climate change mitigation : an assessment

Date of Acceptance: 08/05/2014 Acknowledgements The authors are indebted to Julia Römer for assisting with editing several hundred references. Helmut Haberl gratefully acknowledges funding by the Austrian Academy of Sciences (Global Change Programme), the Austrian Ministry of Science and Research (BMWF, proVision programme) as well as by the EU-FP7 project VOLANTE. Carmenza Robledo-Abad received financial support from the Swiss State Secretariat for Economic Affairs.

The Burden of Burnout: An Assessment of Burnout Among Internal Medicine Residents After the 2011 Duty Hour Changes.

This study sought to determine burnout prevalence and factors associated with burnout in internal medicine residents after introduction of the 2011 ACGME duty hour rules. Burnout was evaluated using an anonymized, abbreviated version of the Maslach Burnout Inventory. Surveys were collected biweekly for 48 weeks during the 2013-2014 academic year. Burnout severity was compared across subgroups and time. A score of 3 or higher signified burnout. Overall, 944 of 3936 (24%) surveys were completed. The mean burnout score across all surveys was 2.8. Categorical residents had higher burnout severity than noncategorical residents (2.9 vs 2.7, P = .005). Postgraduate year 2 residents had the highest burnout severity by year (3.1, P < .001). Residents on inpatient rotations had higher burnout severity than residents on outpatient or consultation rotations (3.1 vs 2.2 vs 2.2, P < .001). Night float rotations had the highest severity (3.8). Burnout remains a significant problem even with recent duty hour modifications.

Isotopic measurements of 3 foraminifer species from ODP Hole 171-1050C

Analysis of 944 single specimens of three species of late Maastrichtian planktonic foraminifera (Racemiguembelina fructicosa, Contusotruncana contusa, and Rugoglobigerina rugosa) from 38 samples spanning the last 3 Myr of the Cretaceous shows consistent isotopic trends through time, consistent isotopic differences among taxa, and high within-sample isotopic variability throughout. Within-sample variability does not change systematically through time for any taxon, but average d18O values decrease by approx. 1.5 per mill, and average d13C values diverge up section. Comparing taxa, average d18O values are similar within most samples, but average d13C values generally decrease from R. fructicosa to R. rugosa to C. contusa. In addition, the within-sample variability of individual d13C measurements is larger for R. fructicosa than for either C. contusa or R. rugosa, an observation which is consistent with a photosymbiotic habitat for R. fructicosa. In terms of Maastrichtian paleoceanography the negative d18O trend of approx. 1.5 per mill corresponds to a temperature increase of approx. 6°C, and the divergence of d13C values up section suggests an increasingly stratified water column in the western Atlantic through the late Maastrichtian. We suggest that these trends are best explained by increasing import of South Atlantic waters into the North Atlantic and an intensification of the Northern Hemisphere polar front.