To assess the measurement properties of EQ-5D-3L and EQ-5D-5L in patients with a major lower limb amputation (LLA).
This was a retrospective register-based study using data from the Swedish ...Amputation and Prosthetics Registry (SwedeAmp). Patients with a six-months follow-up (including either EQ-5D-3L or EQ-5D-5L) after a major unilateral LLA were included. The measurement properties of EQ-5D-3L and EQ-5D-5L were compared in terms of feasibility, response patterns, informativity, and convergent and known-group validity.
The sample included 700 patients with below-knee amputation (76%), above-knee amputation (18%), or knee disarticulation (7%). Responses to EQ-5D-3L and −5L were similar regarding feasibility (98% completion rate) and the proportion reporting no problems (7% and 6%). Compared to EQ-5D-3L, EQ-5D-5L showed higher absolute and relative informativity in all dimensions, with the largest improvement in the mobility dimension. In the analyses of convergent validity, the EQ-5D-5L generally showed stronger correlations with disease-specific measures. Only EQ-5D-5L was able to discriminate between subgroups with different amputation levels.
The findings support the use of EQ-5D-5L over EQ-5D-3L in patients with an LLA, mainly due to improved informativity and improved convergent and known-group validity.
Implications for rehabilitation
The measurement properties of two EQ-5D versions, EQ-5D-3L and EQ-5D-5L, has so far not been evaluated in patients with a lower limb amputation (LLA)
The results support the use of EQ-5D-5L over the use of EQ-5D-3L, mainly due to improved informativity and stronger correlations with disease-specific patient-reported outcome measures
The five-level version of EQ-5D is recommended for future applications of EQ-5D in clinical outcome studies, health economic evaluations, and in the routine follow-up of patients with a major LLA
In the early rehabilitation process six months after an LLA, the majority of patients reported problems with mobility, pain/discomfort, and usual activities
To study the contribution of hysterectomy to the occurrence of urge-or stress urinary incontinence symptoms.
A population-based, cross-sectional cohort study conducted in 1999.
A university medical ...centre in The Netherlands.
Random sample of 2322 women, between 35 and 70 years of age, from a suburban area in the central part of The Netherlands.
Self-report questionnaire with questions from the Urogenital Distress Inventory, sociodemographic variables and data on obstetric and gynaecological history.
Multivariate logistic regression analysis was used to obtain odds ratios with 95% confidence interval of the type and bothersomeness of urinary incontinence for hysterectomy.
One thousand, six hundred and twenty-six women (70%) responded. The adjusted odds of urge (1.9, 1.4;2.6) and bothersome urge (2.6, 1.4;4.4) urinary incontinence were increased for women who had a hysterectomy. This association was not limited to the elderly but also occurred in women under 60 years of age. No increased odds of stress or bothersome stress incontinence were found.
Meta-analysis has shown that hysterectomy increases the odds of urinary incontinence by 30%. However, a distinction between the different types of urinary incontinence symptoms has not been made. Such a distinction is of importance since urge incontinence gives a significantly greater reduction in health-related quality of life as compared with stress incontinence. Therefore, our finding that women scheduled for hysterectomy have an increased risk of developing urge incontinence symptoms indicates that these women should be counselled about this particular consequence.
The CMS Phase-1 pixel detector upgrade Lowette, S.; Moortgat, S.; Deng, W. ...
Journal of instrumentation,
02/2021, Letnik:
16, Številka:
2
Journal Article
Recenzirano
Odprti dostop
The CMS detector at the CERN LHC features a silicon pixel detector as its innermost subdetector. The original CMS pixel detector has been replaced with an upgraded pixel system (CMS Phase-1 pixel ...detector) in the extended year-end technical stop of the LHC in 2016/2017. The upgraded CMS pixel detector is designed to cope with the higher instantaneous luminosities that have been achieved by the LHC after the upgrades to the accelerator during the first long shutdown in 2013–2014. Compared to the original pixel detector, the upgraded detector has a better tracking performance and lower mass with four barrel layers and three endcap disks on each side to provide hit coverage up to an absolute value of pseudorapidity of 2.5. This paper describes the design and construction of the CMS Phase-1 pixel detector as well as its performance from commissioning to early operation in collision data-taking.
To study the association between depression and the incidence of explicit requests for euthanasia in terminally ill cancer patients.
A prospective cohort study was conducted on 138 consecutive cancer ...patients with an estimated life expectancy of 3 months or less, in the period between September 1999 and August 2003. At inclusion, participants completed the Hospital Anxiety and Depression Scale. To identify "depressed mood" we used a cutoff score of 20. Kaplan-Meier curves and Cox regression analyses were used to assess the association between depressed mood and the risk of a request for euthanasia.
Of 138 patients, 32 patients had depressed mood at inclusion. Thirty patients (22%) made an explicit request for euthanasia. The risk to request euthanasia for patients with depressed mood was 4.1 times higher than that of patients without depressed mood at inclusion (95% CI, 2.0 to 8.5).
Depression in cancer patients with an estimated life expectancy of less than 3 months is associated with a higher likelihood to request for euthanasia. The question of whether depressed mood can adequately be treated in this terminally ill population, and if so, whether it would lower the incidence of requests for euthanasia needs further investigation.
ABSTRACT
GRB 230812B is a bright and relatively nearby (z = 0.36) long gamma-ray burst (GRB) that has generated significant interest in the community and has thus been observed over the entire ...electromagnetic spectrum. We report over 80 observations in X-ray, ultraviolet, optical, infrared, and submillimetre bands from the GRANDMA (Global Rapid Advanced Network for Multimessenger Addicts) network of observatories and from observational partners. Adding complementary data from the literature, we then derive essential physical parameters associated with the ejecta and external properties (i.e. the geometry and environment) of the GRB and compare with other analyses of this event. We spectroscopically confirm the presence of an associated supernova, SN2023pel, and we derive a photospheric expansion velocity of v ∼ 17 × 103 km s−1. We analyse the photometric data first using empirical fits of the flux and then with full Bayesian inference. We again strongly establish the presence of a supernova in the data, with a maximum (pseudo-)bolometric luminosity of 5.75 × 1042 erg s−1, at $15.76^{+0.81}_{-1.21}$ d (in the observer frame) after the trigger, with a half-max time width of 22.0 d. We compare these values with those of SN1998bw, SN2006aj, and SN2013dx. Our best-fitting model favours a very low density environment ($\log _{10}({n_{\rm ISM}/{\rm cm}^{-3}}) = -2.38^{+1.45}_{-1.60}$) and small values for the jet’s core angle $\theta _{\rm core} = 1.54^{+1.02}_{-0.81} \ \rm {deg}$ and viewing angle $\theta _{\rm obs} = 0.76^{+1.29}_{-0.76} \ \rm {deg}$. GRB 230812B is thus one of the best observed afterglows with a distinctive supernova bump.
Abstract Objectives To compare the effects of vaginal hysterectomy, subtotal abdominal hysterectomy, and total abdominal hysterectomy on sexual wellbeing. Design Prospective observational study over ...six months. Setting 13 teaching and non-teaching hospitals in the Netherlands. Participants 413 women who underwent hysterectomy for benign disease other than symptomatic prolapse of the uterus and endometriosis. Main outcome measures Reported sexual pleasure, sexual activity, and bothersome sexual problems. Results Sexual pleasure significantly improved in all patients, independent of the type of hysterectomy. The prevalence of one or more bothersome sexual problems six months after vaginal hysterectomy, subtotal abdominal hysterectomy, and total abdominal hysterectomy was 43% (38/89), 41% (31/76), and 39% (57/145), respectively (χ2 test, P = 0.88). Conclusion Sexual pleasure improves after vaginal hysterectomy, subtotal abdominal hysterectomy, and total abdominal hysterectomy. The persistence and development of bothersome problems during sexual activity were similar for all three techniques.
Objective To compare the effects of vaginal hysterectomy (combined with anterior and/or posterior colporraphy) and abdominal sacro‐colpopexy (with preservation of the uterus) on urogenital function.
...Design Randomised trial.
Setting Three teaching hospitals in The Netherlands.
Population Eighty‐two patients undergoing surgical correction of uterine prolapse stages II–IV.
Methods Participating patients completed the urogenital distress inventory (UDI), before and at six weeks, six months and one year after surgery, to measure discomfort of prolapse and micturition symptoms. Domain scores of the UDI (ranging from 0 to 100, higher scores indicating more discomfort) were compared between groups at all time points. Findings at pelvic examination, number of doctor visits within the first year after surgery because of pelvic floor symptoms and performed or planned surgery of recurrent genital prolapse were also compared.
Main outcome measure Domain scores of the UDI at one year after surgery.
Results At one year after surgery, scores on the discomfort/pain domain (mean difference 7.1, 95% confidence interval CI 1.1–13.2), overactive bladder domain (mean difference 8.7, 95% CI 0.5–16.9) and obstructive micturition domain (mean difference 10.3, 95% CI 0.6–20.1) of the UDI were significantly higher in the abdominal group than in the vaginal group. Findings at pelvic examination were similar in both groups. Doctor visits because of pelvic floor symptoms were more frequent in the abdominal group than in the vaginal group. Re‐operation was performed or planned in 9 of the 41 patients who underwent abdominal surgery and in 1 of the 41 patients who underwent vaginal surgery (odds ratio OR = 11.2, 95% CI 1.4–90.0).
Conclusions Our findings suggest that vaginal hysterectomy with anterior and/or posterior colporraphy is preferable to abdominal sacro‐colpopexy with preservation of the uterus as surgical correction in patients with uterine prolapse stages II–IV.
Objectives. To investigate mechanisms of textile failure in explanted human aortic endoprostheses.
Materials and methods. Endoprostheses (
n=31) underwent optical and scanning electron microscopy, ...filament dynamometry, and saturation index measurement.
Results. The macroscopic lesions observed in the Stentor and Vanguard devices were holes at the extremities of the stents and slipping of the warp yarns at the level of sutures or of the longitudinal seams. The macroscopic lesions observed in AneurX endoprostheses were holes, slipping of the warp yarns and ruptures of the ligatures. The macroscopic lesions observed in the two Talent endoprostheses were sections of fibers at the level of the suture holes and few areas lesions of wear, with sometimes holes at the contact of the stent extremities. Stentor, Vanguard and AneurX all demonstrated low saturation indexes of the fabric (44–59%) with an important anisotropy. Whereas the Talent endograft demonstrated a high index of saturation (124–131%) with a low anisotropy. We did not demonstrate significant polymer degradation in any of the endoprostheses.
Conclusions. It is essential to take into account the saturation index to optimally choose a woven textile for the construction of an endoprosthesis since this property of the textile may contribute to explain the macroscopic lesions observed. We did not observe significant polymer degradation by filament dynamometry but further studies are needed to confirm these data.
We report our identification of the optical afterglow and host galaxy of the short-duration gamma-ray burst sGRB 160821B. The spectroscopic redshift of the host is z = 0.162, making it one of the ...lowest redshift short-duration gamma-ray bursts (sGRBs) identified by Swift. Our intensive follow-up campaign using a range of ground-based facilities as well as Hubble Space Telescope, XMM-Newton, and Swift, shows evidence for a late-time excess of optical and near-infrared emission in addition to a complex afterglow. The afterglow light curve at X-ray frequencies reveals a narrow jet, deg, that is refreshed at >1 day post-burst by a slower outflow with significantly more energy than the initial outflow that produced the main GRB. Observations of the 5 GHz radio afterglow shows a reverse shock into a mildly magnetized shell. The optical and near-infrared excess is fainter than AT2017gfo associated with GW170817, and is well explained by a kilonova with dynamic ejecta mass Mdyn = (1.0 0.6) × 10−3 M and a secular (post-merger) ejecta mass with Mpm = (1.0 0.6) × 10−2 M , consistent with a binary neutron star merger resulting in a short-lived massive neutron star. This optical and near-infrared data set provides the best-sampled kilonova light curve without a gravitational wave trigger to date.
Abstract
The CMS Inner Tracker, made of silicon pixel modules, will
be entirely replaced prior to the start of the High Luminosity LHC
period. One of the crucial components of the new Inner Tracker
...system is the readout chip, being developed by the RD53
Collaboration, and in particular its analogue front-end, which
receives the signal from the sensor and digitizes it. Three
different analogue front-ends (Synchronous, Linear, and
Differential) were designed and implemented in the RD53A
demonstrator chip. A dedicated evaluation program was carried out to
select the most suitable design to build a radiation tolerant pixel
detector able to sustain high particle rates with high efficiency
and a small fraction of spurious pixel hits. The test results showed
that all three analogue front-ends presented strong points, but also
limitations. The Differential front-end demonstrated very low noise,
but the threshold tuning became problematic after
irradiation. Moreover, a saturation in the preamplifier feedback
loop affected the return of the signal to baseline and thus
increased the dead time. The Synchronous front-end showed very good
timing performance, but also higher noise. For the Linear front-end
all of the parameters were within specification, although this
design had the largest time walk. This limitation was addressed and
mitigated in an improved design. The analysis of the advantages and
disadvantages of the three front-ends in the context of the CMS
Inner Tracker operation requirements led to the selection of the
improved design Linear front-end for integration in the final CMS
readout chip.
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