Symptom Incongruence Trajectories in Lung Cancer Dyads Lyons, Karen S., PhD; Lee, Christopher S., RN, PhD; Bennett, Jill A., RN, PhD ...
Journal of pain and symptom management,
12/2014, Letnik:
48, Številka:
6
Journal Article
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Abstract Context There is little known about the pattern of change in patient-family member symptom incongruence across the lung cancer trajectory. Objectives This study examined trajectories of ...patient-family member incongruence in perceptions of patient physical function, pain severity, fatigue, and dyspnea in lung cancer dyads and explored the association with family member grief after patient death. Methods Lung cancer patients and their family members providing care ( n = 109 dyads) rated patient symptoms and physical function five times over 12 months. Symptom incongruence trajectories were analyzed using multilevel modeling. Results Patient-family member incongruence did not significantly change over time, on average, except in the case of patient physical function where incongruence significantly declined. There was significant variability around trajectories of incongruence for all symptoms except fatigue. Exploratory analysis on a subsample of 22 bereaved family members found that incongruence regarding patient fatigue was associated with family member grief two months after patient death. Conclusion Findings suggest the importance of modeling symptom incongruence over time and taking a dyadic approach to the illness context to identify interventions that promote adjustment and quality of life for both patient and family member.
Many older neutron cross-section evaluations from libraries such as ENDF/B-VI or JENDL-3.2 show deficiencies in energy ranges that are important for criticality safety applications. Consequently, ...these evaluated data may not be adequate for nuclear criticality calculations where effects such as self-shielding, multiple scattering, or Doppler broadening are important. To support the Nuclear Criticality Safety Program, neutron cross-section measurements have been initiated at the Oak Ridge Electron Linear Accelerator (ORELA). ORELA is ideally suited to measure fission, neutron total, and capture cross-sections in the energy range from 1eV to ∼600keV, which is important for many nuclear criticality safety applications.
Satellite instruments provide a vantage point for studying aerosol
loading consistently over different regions of the world. However, the
typical lifetime of a single satellite platform is on the ...order of 5–15 years; thus, for climate studies, the use of multiple satellite sensors
should be considered. Discrepancies exist between aerosol optical depth
(AOD) products due to differences in their information content, spatial and
temporal sampling, calibration, cloud masking, and algorithmic assumptions.
Users of satellite-based AOD time-series are confronted with the challenge
of choosing an appropriate dataset for the intended application. In this
study, 16 monthly AOD products obtained from different satellite sensors and
with different algorithms were inter-compared and evaluated against Aerosol
Robotic Network (AERONET) monthly AOD. Global and regional analyses
indicate that products tend to agree qualitatively on the annual, seasonal
and monthly timescales but may be offset in magnitude. Several approaches
were then investigated to merge the AOD records from different satellites
and create an optimised AOD dataset. With few exceptions, all merging
approaches lead to similar results, indicating the robustness and stability
of the merged AOD products. We introduce a gridded monthly AOD merged
product for the period 1995–2017. We show that the quality of the merged
product is as least as good as that of individual products. Optimal
agreement of the AOD merged product with AERONET further demonstrates the
advantage of merging multiple products. This merged dataset provides a
long-term perspective on AOD changes over different regions of the world,
and users are encouraged to use this dataset.
Summary
While the “precision nutrition” movement is at an early stage of development, several investigations have compared low‐fat versus carbohydrate (CHO)‐modified diets (i.e., low‐or‐reduced‐CHO, ...low glycemic index/load diets, and high‐fiber) in people with normal versus impaired glucose metabolism. The purpose of this scoping review was to summarize evidence in support of the hypothesis that CHO‐modified diets are more effective for weight loss among people with impaired glucose metabolism. Fifteen articles were included in this review: seven retrospective analyses of randomized clinical trials and eight prospective randomized clinical trials with prespecified hypotheses related to a diet (low‐fat vs. CHO‐modified) × phenotype (normal vs. impaired) interaction. Evidence in support of the hypothesis was identified in six of seven retrospective and three of eight prospective studies, which led to a recommendation of CHO‐modified diets as a first‐line option for people with impaired glucose metabolism. However, the evidence in support of this recommendation is relatively weak, and dietary prescriptions should consider additional contextual information that may influence overall dietary adherence. Additional and rigorous research using innovative randomized experimental approaches is needed for stronger dietary weight loss recommendations based on pretreatment glycemic status.
To support the Nuclear Criticality Safety Program, the Oak Ridge Electron Linear Accelerator (ORELA) has been used to measure the total and capture neutron cross sections of several nuclides in the ...energy range from 100 eV to ∼600 keV. Concerns about the use of existing cross section data in nuclear criticality calculations have been a prime motivator for the new cross-section measurements. Our new capture cross sections of aluminium, silicon, chlorine, fluorine and potassium in the energy range from 100 eV to 600 keV are substantially different from the cross sections in evaluated nuclear data files of ENDF/B-VI and JENDL-3.2.
Proven by multiple theoretical and practical studies,
multi-angular spectral polarimetry is ideal for comprehensive retrieval of
properties of aerosols. Furthermore, a large number of advanced space
...polarimeters have been launched recently or planned to be deployed in the
coming few years (Dubovik et al.,
2019). Nevertheless, at present, practical utilization of aerosol products
from polarimetry is rather limited, due to the relatively small number of
polarimetric compared to photometric observations, as well as challenges in
making full use of the extensive information content available in these
complex observations. Indeed, while in recent years several new algorithms
have been developed to provide enhanced aerosol retrievals from satellite
polarimetry, the practical value of available aerosol products from
polarimeters yet remains to be proven. In this regard, this paper presents
the analysis of aerosol products obtained by the Generalized Retrieval of
Atmosphere and Surface Properties (GRASP) algorithm from POLDER/PARASOL
observations. After about a decade of development, GRASP has been adapted
for operational processing of polarimetric satellite observations and
several aerosol products from POLDER/PARASOL observations have been
released. These updated PARASOL/GRASP products are publicly available (e.g.,
http://www.icare.univ-lille.fr, last access: 16 October 2018, http://www.grasp-open.com/products/, last access: 28 March 2020); the dataset used in the current study is
registered under https://doi.org/10.5281/zenodo.3887265 (Chen
et al., 2020). The objective of this study is to comprehensively evaluate the GRASP aerosol
products obtained from POLDER/PARASOL observations. First, the validation of
the entire 2005–2013 archive was conducted by comparing to ground-based
Aerosol Robotic Network (AERONET) data. The subjects of the validation are
spectral aerosol optical depth (AOD), aerosol absorption optical depth
(AAOD) and single-scattering albedo (SSA) at six wavelengths, as well as
Ångström exponent (AE), fine-mode AOD (AODF) and coarse-mode AOD
(AODC) interpolated to the reference wavelength 550 nm. Second, an
inter-comparison of PARASOL/GRASP products with the PARASOL/Operational,
MODIS Dark Target (DT), Deep Blue (DB) and Multi-Angle Implementation of
Atmospheric Correction (MAIAC) aerosol products for the year 2008 was
performed. Over land both satellite data validations and inter-comparisons
were conducted separately for different surface types, discriminated by bins
of normalized difference vegetation index (NDVI): < 0.2, 0.2 ≤
and < 0.4, 0.4 ≤ and < 0.6, and ≥ 0.6. Three
PARASOL/GRASP products were analyzed: GRASP/HP (“High Precision”),
Optimized and Models. These different products are consistent but were
obtained using different assumptions in aerosol modeling with different
accuracies of atmospheric radiative transfer (RT) calculations.
Specifically, when using GRASP/HP or Optimized there is direct retrieval of
the aerosol size distribution and spectral complex index of refraction. When
using GRASP/Models, the aerosol is approximated by a mixture of several
prescribed aerosol components, each with their own fixed size distribution
and optical properties, and only the concentrations of those components are
retrieved. GRASP/HP employs the most accurate RT calculations, while
GRASP/Optimized and GRASP/Models are optimized to achieve the best trade-off
between accuracy and speed. In all these three options, the underlying
surface reflectance is retrieved simultaneously with the aerosol properties,
and the radiative transfer calculations are performed “online” during the
retrieval. All validation results obtained for the full archive of PARASOL/GRASP
products show solid quality of retrieved aerosol characteristics. The
GRASP/Models retrievals, however, provided the most solid AOD products, e.g.,
AOD (550 nm) is unbiased and has the highest correlation (R ∼ 0.92) and the highest fraction of retrievals (∼ 55.3 %)
satisfying the accuracy requirements of the Global Climate Observing System
(GCOS) when compared to AERONET observations. GRASP/HP and GRASP/Optimized
AOD products show a non-negligible positive bias (∼ 0.07) when
AOD is low (< 0.2). On the other hand, the detailed aerosol
microphysical characteristics (AE, AODF, AODC, SSA, etc.) provided by
GRASP/HP and GRASP/Optimized correlate generally better with AERONET than do
the results of GRASP/Models. Overall, GRASP/HP processing demonstrates the
high quality of microphysical characteristics retrieval versus AERONET.
Evidently, the GRASP/Models approach is more adapted for retrieval of total AOD,
while the detailed aerosol microphysical properties are limited when a
mixture of aerosol models with fixed optical properties are used. The results of a comparative analysis of PARASOL/GRASP and MODIS products
showed that, based on validation against AERONET, the PARASOL/GRASP AOD (550 nm) product is of similar and sometimes of higher quality compared to the
MODIS products. All AOD retrievals are more accurate and in good agreement
over ocean. Over land, especially over bright surfaces, the retrieval
quality degrades and the differences in total AOD products increase. The
detailed aerosol characteristics, such as AE, AODF and AODC from
PARASOL/GRASP, are generally more reliable, especially over land. The global
inter-comparisons of PARASOL/GRASP versus MODIS showed rather robust
agreement, though some patterns and tendencies were observed. Over ocean,
PARASOL/Models and MODIS/DT AOD agree well with the correlation coefficient
of 0.92. Over land, the correlation between PARASOL/Models and the different
MODIS products is lower, ranging from 0.76 to 0.85. There is no significant
global offset; though over bright surfaces MODIS products tend to show
higher values compared to PARASOL/Models when AOD is low and smaller values
for moderate and high AODs. Seasonal AOD means suggest that PARASOL/GRASP
products show more biomass burning aerosol loading in central Africa and
dust over the Taklamakan Desert, but less AOD in the northern Sahara. It is
noticeable also that the correlation for the data over AERONET sites are
somewhat higher, suggesting that the retrieval assumptions generally work
better over AERONET sites than over the rest of the globe. One of the
potential reasons may be that MODIS retrievals, in general, rely more on
AERONET climatology than GRASP retrievals. Overall, the analysis shows that the quality of AOD retrieval from
multi-angular polarimetric observations like POLDER is at least comparable
to that of single-viewing MODIS-like imagers. At the same time, the
multi-angular polarimetric observations provide more information on other
aerosol properties (e.g., spectral AODF, AODC, AE), as well as additional
parameters such as AAOD and SSA.
Long-term maintenance of weight loss requires sustained energy balance at the reduced body weight. This could be attained by coupling low total daily energy intake (TDEI) with low total daily energy ...expenditure (TDEE; low energy flux), or by pairing high TDEI with high TDEE (high energy flux). Within an environment characterized by high energy dense food and a lack of need for movement, it may be particularly difficult for weight-reduced individuals to maintain energy balance in a low flux state. Most of these individuals will increase body mass due to an inability to sustain the necessary level of food restriction. This increase in TDEI may lead to the re-establishment of high energy flux at or near the original body weight. We propose that following weight loss, increasing physical activity can effectively re-establish a state of high energy flux without significant weight regain. Although the effect of extremely high levels of physical activity on TDEE may be constrained by compensatory reductions in non-activity energy expenditure, moderate increases following weight loss may elevate energy flux and encourage physiological adaptations favorable to weight loss maintenance, including better appetite regulation. It may be time to recognize that few individuals are able to re-establish energy balance at a lower body weight without permanent increases in physical activity. Accordingly, there is an urgent need for more research to better understand the role of energy flux in long-term weight maintenance.
Epidemiological studies suggest that poor growth during fetal life and infancy is associated with decreased bone mass in adulthood. However, theses observations have not, to date, been corroborated ...in animal models. To address this issue we evaluated the influence of maternal protein restriction on bone mass and growth plate morphology among the adult offspring, using a rat model. Maternal protein restriction resulted in a reduction in bone area and BMC, but not BMD, among the offspring in late adulthood. The widened epiphyseal growth plate in the protein-restricted offspring is compatible with the programming of cartilage and bone growth by maternal nutrition in early life.
Despite well-documented health benefits from exercise, a study on national trends in achieving the recommended minutes of physical activity guidelines has not improved since the guidelines were ...published in 2008. Peer interactions have been identified as a critical factor for increasing a population’s physical activity. The objective of this study is for establishing criteria for social influences on physical activity for establishing criteria that lead to exercise persistence. A system of differential equations was developed that projects exercise trends over time. The system includes both social and non-social influences that impact changes in physical activity habits and establishes quantitative conditions that delineate population-wide persistence habits from domination of sedentary behavior. The model was generally designed with parameter values that can be estimated to data. Complete absence of social or peer influences resulted in long-term dominance of sedentary behavior and a decline of physically active populations. Social interactions between sedentary and moderately active populations were the most important social parameter that influenced low active populations to become and remain physically active. On the other hand, social interactions encouraging moderately active individuals to become sedentary drove exercise persistence to extinction. Communities should focus on increasing social interactions between sedentary and moderately active individuals to draw sedentary populations to become more active. Additionally, reducing opportunities for moderately active individuals to engage with sedentary individuals through sedentary social activities should be addressed.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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