Tools for Assessing Outcomes in Studies of Chronic Cough: CHEST Guideline and Expert Panel Report

BACKGROUND: Since the publication of the 2006 American College of Chest Physicians (CHEST) cough guidelines, a variety of tools has been developed or further refined for assessing cough. The purpose of the present committee was to evaluate instruments used by investigators performing clinical research on chronic cough. The specific aims were to (1) assess the performance of tools designed to measure cough frequency, severity, and impact in adults, adolescents, and children with chronic cough and (2) make recommendations or suggestions related to these findings.

METHODS: By following the CHEST methodologic guidelines, the CHEST Expert Cough Panel based its recommendations and suggestions on a recently published comparative effectiveness review commissioned by the US Agency for Healthcare Research and Quality, a corresponding summary published in CHEST, and an updated systematic review through November 2013. Recommendations or suggestions based on these data were discussed, graded, and voted on during a meeting of the Expert Cough Panel.

RESULTS: We recommend for adults, adolescents (≥ 14 years of age), and children complaining of chronic cough that validated and reliable health-related quality-of-life (QoL) questionnaires be used as the measurement of choice to assess the impact of cough, such as the Leicester Cough Questionnaire and the Cough-Specific Quality-of-Life Questionnaire in adult and adolescent patients and the Parent Cough-Specific Quality of Life Questionnaire in children. We recommend acoustic cough counting to assess cough frequency but not cough severity. Limited data exist regarding the performance of visual analog scales, numeric rating scales, and tussigenic challenges.

CONCLUSIONS: Validated and reliable cough-specific health-related QoL questionnaires are recommended as the measurement of choice to assess the impact of cough on patients. How they compare is yet to be determined. When used, the reporting of cough severity by visual analog or numeric rating scales should be standardized. Previously validated QoL questionnaires or other cough assessments should not be modified unless the new version has been shown to be reliable and valid. Finally, in research settings, tussigenic challenges play a role in understanding mechanisms of cough.

Early-type stars observed in the ESO UVES Paranal observatory project - IV. studies of CN, CH+ and CH in the interstellar medium

High spectral resolution (~80 000) and signal-to-noise observations from the Ultraviolet and Visual Echelle Spectrograph Paranal Observatory Project (UVES-POP) are used to study the interstellarmolecular lines CN (3874 Å), CH⁺ (3957, 4232 Å) and CH (3886, 4300 Å) towards 74 O- and B-type stellar sightlines. Additionally, archive data are presented for 140 ELODIE early-type stellar sightlines at R = 42 000, plus 25 FEROS at R = 48 000 and 3 UVES at R > 50 000, mainly in the CH⁺ (4232 Å) and CH (3886, 4300 Å) transitions. Detection rates are ~45 per cent for CN and ~67 per cent for the other lines in the POP sample, and ~10-15 per cent for CH⁺ and CH lines in the additional sample. CH and CH⁺ are well correlated between log[N(CH) cm^-2]~12-14, implying that these clouds are CH⁺-like CH and not CN-like CH. CH is also very well correlated with Na I D in the range log[N(Na I cm^-2]) ~12.2-14.2. A few sightlines show tentative velocity shifts of ~2 km s^-1 between CH and CH⁺, which appear to be caused by differences in component strength in blends, and hence do not provide firm evidence for shocks. Finally, we describe a search for ¹³CH⁺ in a sightline towards HD 76341. No ¹³CH⁺ is detected, placing a limit on the ¹³CH⁺ to ¹²CH⁺ ratio of ~0.01. If a formal fit is attempted, the equivalent width ratio in the two isotopes is a factor ~90 but with large errors. 

Three essays on the psychology of investment and financial markets

Préface My thesis consists of three essays where I consider equilibrium asset prices and investment strategies when the market is likely to experience crashes and possibly sharp windfalls. Although each part is written as an independent and self contained article, the papers share a common behavioral approach in representing investors preferences regarding to extremal returns. Investors utility is defined over their relative performance rather than over their final wealth position, a method first proposed by Markowitz (1952b) and by Kahneman and Tversky (1979), that I extend to incorporate preferences over extremal outcomes. With the failure of the traditional expected utility models in reproducing the observed stylized features of financial markets, the Prospect theory of Kahneman and Tversky (1979) offered the first significant alternative to the expected utility paradigm by considering that people focus on gains and losses rather than on final positions. Under this setting, Barberis, Huang, and Santos (2000) and McQueen and Vorkink (2004) were able to build a representative agent optimization model which solution reproduced some of the observed risk premium and excess volatility. The research in behavioral finance is relatively new and its potential still to explore. The three essays composing my thesis propose to use and extend this setting to study investors behavior and investment strategies in a market where crashes and sharp windfalls are likely to occur. In the first paper, the preferences of a representative agent, relative to time varying positive and negative extremal thresholds are modelled and estimated. A new utility function that conciliates between expected utility maximization and tail-related performance measures is proposed. The model estimation shows that the representative agent preferences reveals a significant level of crash aversion and lottery-pursuit. Assuming a single risky asset economy the proposed specification is able to reproduce some of the distributional features exhibited by financial return series. The second part proposes and illustrates a preference-based asset allocation model taking into account investors crash aversion. Using the skewed t distribution, optimal allocations are characterized as a resulting tradeoff between the distribution four moments. The specification highlights the preference for odd moments and the aversion for even moments. Qualitatively, optimal portfolios are analyzed in terms of firm characteristics and in a setting that reflects real-time asset allocation, a systematic over-performance is obtained compared to the aggregate stock market. Finally, in my third article, dynamic option-based investment strategies are derived and illustrated for investors presenting downside loss aversion. The problem is solved in closed form when the stock market exhibits stochastic volatility and jumps. The specification of downside loss averse utility functions allows corresponding terminal wealth profiles to be expressed as options on the stochastic discount factor contingent on the loss aversion level. Therefore dynamic strategies reduce to the replicating portfolio using exchange traded and well selected options, and the risky stock.

Studies on oxamyl : analytical method development and investigation of fate in peach seedlings and corn seeds

A high performance liquid chromatographic method employing two columns connected in series and separated~y·a.switching valve has been developed for the analysis of the insecticide/ nematicide oxamyl (methyl-N' ,N'-dimethyl-N-[(methylcarbamoyl) oxy]-l-thiooxarnimidate) and two of its metabolites. A variation of this method involving two reverse phase columns was employed to monitor the persistence and translocation of oxamyl in treated peach seedlings. It was possible to simultaneously analyse for oxamyl and its corresponding oxime (methyl-N',N'-dimethyl-N-hydroxy-l-thiooxamimidate}, a major metabolite of oxamyl in plants, without prior cleanup of the samples. The method allowed detection of 0.058 pg oxamyl and 0.035 p.g oxime. On treated peach leaves oxamyl was found to dissipate rapidly during the first two-week period, followed by a period of slow decomposition. Movement of oxamyl or its oxime did not occur in detectable quantities to untreated leaves or to the root or soil. A second variation of the method which employed a size exclusion column as·the first column and a reverse phase column as the second was used to monitor the degradation of oxamyl in treated, planted corn seeds and was suitable for simultaneous analysis of oxamyl, its oxime and dimethylcyanoformamide (DMCF), a metabolite of oxamyl. The method allowed detection of 0.02 pg oxamyl, 0.02 p.g oxime and 0.005 pg DMCF. Oxamyl was found to persist for a period of 5 - 6 weeks, which is long enough to permit oxamyl seedtreatment to be considered as a potential means of protecting young corn plants from nematode attack. Decomposition was found to be more rapid in unsterilized soil than in sterililized soil. DMCF was found to have a nematostatic effect at high concentrations ( 2,OOOpprn), but at lower concentrations no effect on nematode mobility was observed. Oxamyl, on the other hand, was found to reduce the mobility of nematodes at concentrations down to 4 ppm.

Studies on the insecticide - nematicide-oxamyl and its quantitative determination by gas chromatographic method

Ox amyl , an insecticide/nematicide with the chemical name; methyl ~'. ~·-dimethyl-~-(methylcarbamoyl)oxy-l-thiooxamimidate, and its major degradation compound; oxime or oximino compound, methyl ~',~'-dimethyl-~-hydroxy-l-thiooxamimidate were studied in this work. NMR and mass spectrometry were utilized in the structural studies. An attempt was made to explain the fragmentation patterns of some major peaks in the mass spectra of oxamyl and oxime. A new gas chromatographic method for the detection and determination of submicrogram levels of intact oxamyl using a electron-capture detector was developed. The principle of this method is to produce a derivative which is highly sensitive to an electron-capture detector. The derivative described is dinitrophenyl methylamine( DNPMA ) • Experimental conditions such as pH , reaction temperature , reaction time, the amount of reagent ( Dinitrofluaro benzene) etc. were thoroughly investigated and optimized. This method was successfully applied to the determination of oxamyl residues in tobacco leaves and soil. Throughout this J9D:oject , thin layer chromatography was also used in the separation:and clean up of oxamyl and oxime samples.

DFT Studies of the Organocatalytic Aldol Reaction and a Frustrated Lewis Pair

The computational study, and in particular the density functional theory (DFT) study of the organocatalytic α-chlorination-aldol reaction and the chiral backbone Frustrated Lewis Pair (FLP) system served as a valuable tool for experimental purposes. This thesis describes methods to consider different transition states of the proline- catalyzed α-chlorination aldol reaction to determine the reasonable transition state in the reaction between the enamine and α-chloro aldehydes. Moreover, the novel intramolecular Frustrated Lewis pair based on a chiral backbone for the asymmetric hydrogenation of imines and enamines was designed and the ability of hydrogen splitting by this new FLP system was examined by computational modeling and calculating the hydrogen activation energy barrier.

Élaboration d’un modèle théorique pour étudier le rapport au savoir en didactique de l’histoire et en éducation à la citoyenneté

Ce mémoire a pour objet d’étude la notion du rapport aux savoirs historiques des élèves de l’ordre secondaire. Plus précisément, il sera question des relations existant entre la conception qu’entretiennent les élèves de l’histoire et du métier de l’historien, leur conception de l’action humaine dans l’histoire et leur sentiment d’être eux-mêmes, aujourd’hui, des acteurs politiques effectifs. Ce sujet est ancré dans le contexte de l’introduction des prescriptions en matière d’éducation à la citoyenneté dans le programme d’histoire de niveau secondaire. Cet ajout a pour conséquence d’introduire de nouveaux objectifs en matière d’éducation à la citoyenneté : l’élève, par l’étude de l’évolution démocratique, doit être amené à comprendre le rôle de l’action humaine dans l’histoire, lui faisant ainsi comprendre la valeur de sa propre participation à la vie sociale et politique. Cela étant dit, les recherches montrent que les enseignants et les enseignantes tardent à adopter la terminologie propre aux compétences du programme de formation en histoire et éducation à la citoyenneté et perpétuent un enseignement de l’histoire-récit qui fait la part belle aux grands évènements et aux grands hommes (Bouhon, 2009; Moisan, 2011). De plus, les manuels utilisés laissent peu de place aux individus ou aux groupes d’individus agissants et présentent rarement leurs actions de manière à rendre compte de leur efficacité (Éthier, 2001; Lefrançois, Éthier et Demers, 2011). Enfin, les recherches montrent que les élèves sont enclins à expliquer les changements à l’aide d’une histoire personnalisante, occupée principalement par les grands hommes et les hauts faits de l’histoire politique et militaire (Hallden, 1986 ; Carretero, Jacott, Limon, Lopez-Manjon et Leon, 1994 ; Carretero, Asuncion et Jacott, 1997 ; Tutiaux-Guillon et Fourmond, 1998). En explorant les conséquences complexes de ces différents constats, nous avons ressenti une insatisfaction à l’égard de la capacité d’explication de ce phénomène qu’offrait le champ conceptuel de didactique de l’histoire. Par conséquent, ce mémoire portera sur le transfert de la notion de rapport au savoir au domaine de la didactique de l’histoire à partir de la sociologie et de l’anthropologie. Le modèle théorique proposé a été obtenu grâce à une recherche spéculative qui a été inspirée des méthodes de Martineau, Simard et Gauthier (2001) et de Van der Maren (1996).

L’évolution des représentations sur les langues d’élèves plurilingues du 3e cycle du primaire lors de l’implantation d’un projet d’Éveil aux langues

La présente recherche documente l’évolution des représentations sur les langues de cinq cas d’élèves plurilingues et immigrants ou issus de l’immigration, scolarisés en fin de cycle du primaire en milieu pluriethnique à Montréal, tout au long de l’implantation d’un projet d’Éveil aux langues, sur une période de deux ans. La méthodologie adoptée permet de décrire en profondeur et de façon nuancée, l’évolution des représentations des élèves sur les langues de leur répertoire plurilingue d’une part, et plus largement, sur les langues et de la diversité linguistique d’autre part. Les résultats de la recherche ont permis de mettre en évidence que l’implantation d’un projet d’Éveil aux langues sur deux ans : 1) a des effets positifs sur les représentations sur la diversité linguistique de ces élèves; 2) permet de soutenir le développement de représentations positives sur les langues du répertoire linguistique des élèves qui passe par l’acceptation de compétences partielles dans l’une ou l’autre des langues de leur répertoire et par l’expression d’un sentiment de fierté à propos de leur répertoire plurilingue; 3) permet le développement, chez les élèves, de diverses stratégies pour légitimer l’intégration de langues dans lesquelles ils ont des compétences partielles au sein de leur répertoire linguistique : apporter un jugement de valeur sur leurs compétences, spécifier leur domaine de compétence (expression orale ou écrite, compréhension orale ou écrite), qualifier, étiqueter leurs langues (langue maternelle, langue d’origine, langue seconde), adapter les définitions formelles présentées dans le projet sur le plurilinguisme à leur situation; 4) les représentations sur les langues par les élèves peuvent être marquées par le poids des représentations sociales; toutefois, cette tendance se lénifie au fur et à mesure de l’implantation du projet et une majorité d’élèves partage des représentations plus individualisées et moins marquées par des stéréotypes en fin de projet; 5) permet, pour les élèves de niveau scolaire fort et moyen, le développement d’un vocabulaire de haut niveau ainsi que le développement d’une curiosité envers la langue de l’Autre; 6) permet, pour les élèves de niveau scolaire faible, et à partir de la seconde année d’implantation, le développement d’un engagement dans les activités qui passe par une participation accrue au projet et le développement de compétence langagière (meilleure qualité argumentative); 7) offre la possibilité aux élèves de se connaître les uns les autres, d’être à l’écoute de l’Autre et d’exprimer de la curiosité envers la langue de l’autre et de reconnaître l’expertise de l’Autre, ceci participant à la mise en place d’une dynamique relationnelle propice aux apprentissages

STUDIES ON THE CHARACTERISTICS OF TROPOSPHERE AND LOWER STRATOSPHERE ASSOCIATED WITH THE PASSAGE OF TROPICAL CYCLONES

In the present thesis, an attempt has been made to study the characteristics of troposphere and lower stratosphere during the passage of tropical cyclones from a tropical station in India using MST radar. MST radar is an excellent tool for studying various features of the atmosphere from ground to mesospheric heights, as it can be operated continuously with good time and altitude resolution. The major objectives are to identify the multiple layers of reflectivity observed in the atmosphere during cyclones, to study the troposphere characteristics during these cyclones and its dependence on cyclone position and intensity, to detect the waves present in the atmosphere, to study the transport of momentum fluxes and to understand stratosphere. The winds in the troposphere and lower stratosphere are greatly affected by the passage of cyclones; the presence of high reflectivity layers below the tropopause suggests the passage of severe weather systems etc. are some of the major findings of the study. The study can be extended further to understand the circulation and dynamics of the atmosphere associated with the passage of tropical cyclones. The gravity wave generation and its characteristics during the passage of storms is another important aspect to be studied in detail.

Ecological and Biochemical Studies On Cyanobacteria of Cochin Estuary and Their Application as Source of Antioxidants

The main objectives of the present investigation were to evaluate the qualitative and quantitative distribution of natural cyanobacterial population and their ecobiological properties along the Cochin estuary and their application in aquaculture systems as a nutritional supplement due to their nutrient-rich biochemical composition and antioxidant potential. This thesis presents a detailed account of the distribution of cyanobacteria in Cochin estuary, an assessment of physico-chemical parameters and the nutrients of the study site, an evaluation of the effect of physico-chemical parameters on cyanobacterial distribution and abundance, isolation, identification and culturing of cyanobacteria, the biochemical composition an productivity of cyanobacteria, and an evaluation of the potential of the selected cyanobacteria as antioxidants against ethanol induced lipid peroxidation. The pH, salinity and nutritional requirements were optimized for low-cost production of the selected cyanobacterial strains. The present study provides an insight into the distribution, abundance, diversity and ecology of cyanobacteria of Cochin estuary. From the results, it is evident that the ecological conditions of Cochin estuary support a rich cyanobacterial growth.