Background
Grading of equine gastric ulcer syndrome (EGUS) is undertaken in clinical and research settings, but the reliability of EGUS grading systems is poorly understood.
Hypothesis/Objectives
...Investigate interobserver and intraobserver reliability of an established ordinal grading system and a novel visual analog scale (VAS), and assess the influence of observer experience.
Animals
Sixty deidentified gastroscopy videos.
Methods
Six observers (3 specialists and 3 residents) graded videos using the EGUS Council (EGUC) system and VAS. Observers graded the videos three 3 for each system, using a cross‐over design with at least 1 week between each phase. The order of videos was randomized for each phase.
Methods
Interobserver and intraobserver reliability were estimated using Gwet's agreement coefficient with ordinal weights applied (AC2) for the EGUC system and the intraclass correlation coefficient (ICC) for the VAS.
Results
Using the EGUC system, interobserver reliability was substantial for squamous (AC2 = 0.69; 95% confidence interval CI, 0.57‐0.80) and glandular mucosa (AC2 = 0.72; 95% CI, 0.70‐0.75), and intraobserver reliability was substantial for squamous (AC2 = 0.80; 95% CI, 0.71‐0.90) and glandular mucosa (AC2 = 0.80; 95% CI, 0.74‐0.86). Interobserver reliability using the VAS was moderate for squamous (ICC = 0.64; 95% CI, 0.31‐0.96) and poor for glandular mucosa (ICC = 0.35; 95% CI, 0.06‐0.64), and intraobserver reliability was moderate for squamous (ICC = 0.74; 95% CI, 0.62‐0.86) and glandular mucosa (ICC = 0.56; 95% CI, 0.39‐0.72).
Conclusions and Clinical Importance
The EGUC system had acceptable intraobserver and interobserver reliability and performed well regardless of observer experience. Familiarity and observer experience improved reliability of the VAS.
The PROSPECT reactor antineutrino experiment Ashenfelter, J.; Balantekin, A.B.; Baldenegro, C. ...
Nuclear instruments & methods in physics research. Section A, Accelerators, spectrometers, detectors and associated equipment,
04/2019, Letnik:
922
Journal Article
Recenzirano
Odprti dostop
The Precision Reactor Oscillation and Spectrum Experiment, PROSPECT, is designed to make both a precise measurement of the antineutrino spectrum from a highly-enriched uranium reactor and to probe ...eV-scale sterile neutrinos by searching for neutrino oscillations over meter-long baselines. PROSPECT utilizes a segmented6Li-doped liquid scintillator detector for both efficient detection of reactor antineutrinos through the inverse beta decay reaction and excellent background discrimination. PROSPECT is a movable 4-ton antineutrino detector covering distances of 7m to 13m from the High Flux Isotope Reactor core. It will probe the best-fit point of the ν̄e disappearance experiments at 4σ in 1 year and the favored regions of the sterile neutrino parameter space at more than 3σ in 3 years. PROSPECT will test the origin of spectral deviations observed in recent θ13 experiments, search for sterile neutrinos, and address the hypothesis of sterile neutrinos as an explanation of the reactor anomaly. This paper describes the design, construction, and commissioning of PROSPECT and reports first data characterizing the performance of the PROSPECT antineutrino detector.
Background Chest pain in the absence of obstructive coronary artery disease (CAD) is common in women; it is frequently associated with debilitating symptoms and repeated evaluations and may be caused ...by coronary microvascular dysfunction. However, the prevalence and determinants of microvascular dysfunction in these women are uncertain. Methods We measured coronary flow velocity reserve (coronary velocity response to intracoronary adenosine) to evaluate the coronary microvasculature and risk factors for atherosclerosis in 159 women (mean age, 52.9 years) with chest pain and no obstructive CAD. All women were referred for coronary angiography to evaluate their chest pain as part of the Women’s Ischemia Syndrome Evaluation (WISE) study. Results Seventy-four (47%) women had subnormal (<2.5) coronary flow velocity reserve suggestive of microvascular dysfunction (mean, 2.02 ± 0.38); 85 (53%) had normal reserve (mean, 3.13 ± 0.64). Demographic characteristics, blood pressure, ventricular function, lipid levels, and reproductive hormone levels were not significantly different between women with normal and those with abnormal microvascular function. Postmenopausal hormone use within 3 months was significantly less prevalent among those with microvascular dysfunction (40% vs 60%, P =.032). Age and number of years past menopause correlated with flow velocity reserve (r = –0.18, P =.02, and r = –0.30, P <.001, respectively). No significant associations were identified between flow velocity reserve and lipid and hormone levels, blood pressure, and left ventricular ejection fraction. Conclusions Coronary microvascular dysfunction is present in approximately one half of women with chest pain in the absence of obstructive CAD and cannot be predicted by risk factors for atherosclerosis and hormone levels. Therefore, the diagnosis of coronary microvascular dysfunction should be considered in women with chest pain not attributable to obstructive CAD. (Am Heart J 2001;141:735-41.)
The 2013 multistate outbreaks contributed to the largest annual number of reported US cases of cyclosporiasis since 1997. In this paper we focus on investigations in Texas. We defined an ...outbreak-associated case as laboratory-confirmed cyclosporiasis in a person with illness onset between 1 June and 31 August 2013, with no history of international travel in the previous 14 days. Epidemiological, environmental, and traceback investigations were conducted. Of the 631 cases reported in the multistate outbreaks, Texas reported the greatest number of cases, 270 (43%). More than 70 clusters were identified in Texas, four of which were further investigated. One restaurant-associated cluster of 25 case-patients was selected for a case-control study. Consumption of cilantro was most strongly associated with illness on meal date-matched analysis (matched odds ratio 19·8, 95% confidence interval 4·0–∞). All case-patients in the other three clusters investigated also ate cilantro. Traceback investigations converged on three suppliers in Puebla, Mexico. Cilantro was the vehicle of infection in the four clusters investigated; the temporal association of these clusters with the large overall increase in cyclosporiasis cases in Texas suggests cilantro was the vehicle of infection for many other cases. However, the paucity of epidemiological and traceback information does not allow for a conclusive determination; moreover, molecular epidemiological tools for cyclosporiasis that could provide more definitive linkage between case clusters are needed.
Interleukin-6 (IL6) is a pleiotropic pro-inflammatory and immunomodulatory cytokine which probably plays an important role in the pathogenesis of chronic obstructive pulmonary disease (COPD). There ...is a functional single nucleotide polymorphism (SNP), -174G/C, in the promoter region of IL6. It was hypothesised that IL6 SNPs influence susceptibility for impaired lung function and COPD in smokers.
Seven and five SNPs in IL6 were genotyped in two nested case-control samples derived from the Lung Health Study (LHS) based on phenotypes of rate of decline of forced expiratory volume in 1 s (FEV(1)) over 5 years and baseline FEV(1) at the beginning of the LHS. Serum IL6 concentrations were measured for all subjects. A partially overlapping panel of nine IL6 SNPs was genotyped in 389 cases of COPD from the National Emphysema Treatment Trial (NETT) and 420 controls from the Normative Aging Study (NAS).
In the LHS, three IL6 SNPs were associated with decline in FEV(1) (0.023< or =p< or =0.041 in additive models). Among them, the IL6_-174C allele was associated with a rapid decline in lung function. The association was more significant in a genotype-based analysis (p = 0.006). In the NETT-NAS study, IL6_-174G/C and four other IL6 SNPs, all of which are in linkage disequilibrium with IL6_-174G/C, were associated with susceptibility to COPD (0.01< or =p< or =0.04 in additive genetic models).
The results suggest that the IL6_-174G/C SNP is associated with a rapid decline in FEV(1) and susceptibility to COPD in smokers.
Severe maternal morbidity in Scotland Masterson, J. A.; Adamestam, I.; Beatty, M. ...
Anaesthesia,
September 2022, 2022-09-00, 20220901, Letnik:
77, Številka:
9
Journal Article
Recenzirano
Odprti dostop
Summary
Using a cohort study design, we analysed 17 diagnoses and 9 interventions (including critical care admission) as a composite measure of severe maternal morbidity for pregnancies recorded over ...14 years in Scotland. There were 762,918 pregnancies, of which 7947 (10 in 1000 pregnancies) recorded 9345 severe maternal morbidity events, 2802 episodes of puerperal sepsis being the most common (30%). Severe maternal morbidity incidence increased from 9 in 1000 pregnancies in 2012 to 17 in 1000 pregnancies in 2018, due in part to puerperal sepsis recording. The odds ratio (95%CI) for severe maternal morbidity was higher for: older women, for instance 1.22 (1.13–1.33) for women aged 35–39 years and 1.44 (1.27–1.63) for women aged > 40 years compared with those aged 25–29 years; obese women, for instance 1.13 (1.06–1.21) for BMI 30–40 kg.m‐2 and 1.32 (1.15–1.51) for BMI > 40 kg.m‐2 compared with BMI 18.5–24.9 kg.m‐2; multiple pregnancy, 2.39 (2.09–2.74); and previous caesarean delivery, 1.52 (1.40–1.65). The median (IQR range) hospital stay was 3 (2–5 1–8) days with severe maternal morbidity and 2 (1–3 1–5) days without. Forty‐one women died during pregnancy or up to 42 days after delivery, representing mortality rates per 100,000 pregnancies of about 365 with severe maternal morbidity and 1.6 without. There were 1449 women admitted to critical care, 807 (58%) for mechanical ventilation or support of at least two organs. We recorded an incidence of severe maternal morbidity higher than previously published, possibly because sepsis was coded inaccurately in our databases. Further research may determine the value of this composite measure of severe maternal morbidity.
Determinants of muscle carnosine content Harris, R. C.; Wise, J. A.; Price, K. A. ...
Amino Acids,
07/2012, Letnik:
43, Številka:
1
Journal Article, Book Review
Recenzirano
Odprti dostop
The main determinant of muscle carnosine (M-Carn) content is undoubtedly species, with, for example, aerobically trained female vegetarian athletes with
circa
13 mmol/kg dry muscle (dm) having just ...1/10th of that found in trained thoroughbred horses. Muscle fibre type is another key determinant, as type II fibres have a higher M-Carn or muscle histidine containing dipeptide (M-HCD) content than type I fibres. In vegetarians, M-Carn is limited by hepatic synthesis of β-alanine, whereas in omnivores this is augmented by the hydrolysis of dietary supplied HCD’s resulting in muscle levels two or more times higher. β-alanine supplementation will increase M-Carn. The same increase in M-Carn occurs with administration of an equal molar quantity of carnosine as an alternative source of β-alanine. Following the cessation of supplementation, M-Carn returns to pre-supplementation levels, with an estimated t
1/2
of 5–9 weeks. Higher than normal M-Carn contents have been noted in some chronically weight-trained subjects, but it is unclear if this is due to the training
per se
, or secondary to changes in muscle fibre composition, an increase in β-alanine intake or even anabolic steroid use. There is no measureable loss of M-Carn with acute exercise, although exercise-induced muscle damage may result in raised plasma concentrations in equines. Animal studies indicate effects of gender and age, but human studies lack sufficient control of the effects of diet and changes in muscle fibre composition.
The PROSPECT physics program Ashenfelter, J; Balantekin, A B; Band, H R ...
Journal of physics. G, Nuclear and particle physics,
10/2016, Letnik:
43, Številka:
11
Journal Article
Recenzirano
Odprti dostop
The precision reactor oscillation and spectrum experiment, PROSPECT, is designed to make a precise measurement of the antineutrino spectrum from a highly-enriched uranium reactor and probe eV-scale ...sterile neutrinos by searching for neutrino oscillations over a distance of several meters. PROSPECT is conceived as a 2-phase experiment utilizing segmented 6Li-doped liquid scintillator detectors for both efficient detection of reactor antineutrinos through the inverse beta decay reaction and excellent background discrimination. PROSPECT Phase I consists of a movable 3 ton antineutrino detector at distances of 7-12 m from the reactor core. It will probe the best-fit point of the e disappearance experiments at 4 in 1 year and the favored region of the sterile neutrino parameter space at > 3 in 3 years. With a second antineutrino detector at 15-19 m from the reactor, Phase II of PROSPECT can probe the entire allowed parameter space below 10 eV2 at 5 in 3 additional years. The measurement of the reactor antineutrino spectrum and the search for short-baseline oscillations with PROSPECT will test the origin of the spectral deviations observed in recent θ 13 experiments, search for sterile neutrinos, and conclusively address the hypothesis of sterile neutrinos as an explanation of the reactor anomaly.
We report on an analysis of new Chandra data of the galaxy group HCG 62, well known for possessing cavities in its intragroup medium (IGM) that were inflated by the radio lobes of its central active ...galactic nucleus (AGN). With the new data, a factor of 3 deeper than previous Chandra data, we re-examine the energetics of the cavities and determine new constraints on their contents. We confirm that the ratio of radiative to mechanical power of the AGN outburst that created the cavities is less than 10− 4, among the lowest of any known cavity system, implying that the relativistic electrons in the lobes can supply only a tiny fraction of the pressure required to support the cavities. This finding implies additional pressure support in the lobes from heavy particles (e.g. protons) or thermal gas. Using spectral fits to emission in the cavities, we constrain any such volume-filling thermal gas to have a temperature kT 4.3 keV. For the first time, we detect X-ray emission from the central AGN, with a luminosity of
erg s− 1 and properties typical of a low-luminosity AGN. Finally, we report evidence for a recent merger from the surface brightness, temperature and metallicity structure of the IGM.
Abstract Background Stress is an established important contributor to the development of mental illness and stress related disorders. The biology implicated in the homeostasis of pathological stress ...mechanisms is not fully established. One of the difficulties with current techniques is the limitation in capturing chronic levels of cortisol as an expression of stress levels in humans. Hair samples can be used to evaluate cortisol levels averaged over relatively long periods of time, therefore providing a more valid measure of chronic levels of this hormone. A highly replicable technique to measure long-term cortisol could prove pivotal in improving our understanding of the role of stress in psychiatric disorders. Methods This review synthesises all the published studies relating hair cortisol concentration (HCC) to stress and to psychiatric disorders. It describes and summarises their findings with the aim of providing a summary picture of the current state of this line of research. Results The strongest finding to date is the replicable increases in hair cortisol associated with stressful life events. Findings in psychiatric disorders are more sparse and inconsistent. There is some support for the presence of raised HCC in major depressive disorders, and for lowered HCC in posttraumatic stress disorder, suggesting chronic hypercortisolaemia and hypocortisolaemia respectively. Conclusions HCC is a promising methodology to study chronic cortisol levels with the potential to help characterise psychiatric and stress related disorders. The combination of chronic and acute cortisol measurements has the potential for more accurately determining different aspects of the stress response, and ultimately for the development of a biological marker to aid diagnosis and response to treatment.
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