Exosomes, small membrane vesicles （30-100 nm） of endocytic origin secreted by most cell types, contain functional biomolecules, which can be horizontally transferred to recipient cells 1. Exosomes ...bear a specific protein and lipid composition, and carry a select set of functional mRNAs and microRNAs 2. Recently, our group has shown that c-Met shed in exosomes can promote a proangiogenic and prometastatic phenotype in bone marrow-derived progenitor cells during melanoma progression 3. In previous research, retrotransposon RNA transcripts, single-stranded DNA （ssDNA）,
From Field and Study Woods, Robert S.; Ticehurst, Claud B.; Howell, A. Brazier ...
The Condor (Los Angeles, Calif.),
01/1934, Volume:
36, Issue:
1
Journal Article
The Short Form 6 Dimension (SF-6D) is a multi-attribute utility instrument derived from the Short-Form 36 Health Survey Version 2 (SF-36v2) quality of life questionnaire and is used to calculate ...quality-adjusted life years (QALYs) on a scale 0 to 1. The SF-6Dv2 is a new version of the SF-6D.
The aim of this study was to assess the consistency of respondents’ answers to 3 different methods to administer this new version.
SF-6Dv2 utility values were generated from the SF-36v2 using the following: (1) full questionnaire with 36 items (SF-6Dv2SF-36); (2) subset questionnaire with 10 items (SF-6Dv2ind-10); (3) SF-6Dv2 administered as an independent instrument (rephrased questionnaire with only 6 items SF-6Dv2ind-6). The order of the 3 instruments was randomly allocated between respondents.
A total of 782 respondents from Quebec, Canada, were interviewed, out of whom 697 fully completed the survey. Very few deviations in respondents’ answers were observed between the 3 instruments, with mean weighted kappa of 0.79 (range 0.61-0.91) and mean global consistency index of 70% (range 54-83). Maximal difference in utility values generated was found between SF-6Dv2ind-10 and SF-6Dv2ind-6 (mean difference 0.016, P < .01), whereas minimal difference was found between SF-6Dv2SF-36 and SF-6Dv2ind-10 (0.002, P = .38). No ceiling effect was observed.
The SF-6Dv2 was designed to derive utilities from the SF-36v2, and our results indicate that it is still preferable to use the full questionnaire, although the difference with other variants of the questionnaire is very small. To use the SF-6Dv2 as an independent instrument will thus introduce minimal bias in utility values generated.
Connectivity as a concept has been increasingly part of discussions or explanations in hydrology, geomorphology and ecology. We address recent critiques of this approach by demonstrating how a ...refinement which distinguishes structural connectivity from functional connectivity can be used to explain patterns observed in very different environmental systems. These systems are found in linkages between surface and subsurface flowpaths and the hyporheos in the River Don, a temperate river channel in Yorkshire, UK; in surface and subsurface fluxes in agricultural land in the UK; and in vegetation and surface conditions in a degrading environment at the Sevilleta LTER site in the semi-arid Southwest USA. First, we demonstrate long-term geological and structural controls mediated by in-channel processes. Second, human organization of landscape elements is a significant control on runoff and erosion, so that similar events can produce very different responses (and
vice versa). Third, linkages between the removal of grass vegetation and runoff and erosion produce non-linear and path-dependent feedbacks which control the subsequent degradation of the landscape, making the process difficult to reverse. As a result of these studies, we argue that even in cases where connectivity cannot be directly quantified (at least at present), this limitation does not prevent the concept from being a useful heuristic device for exploring responses of complex systems. Furthermore, this result implies that an increasing need exists for disciplinary connectivity to investigate such systems.
The widespread adoption of the EuroQol 5-dimensional questionnaire (EQ-5D) has been important for the comparability, transparency, and consistency of economic evaluations for informing resource ...allocation in healthcare. The objectives of this article were to (1) critically assess whether the widespread adoption of the EQ-5D and its time trade-off–based value sets to inform economic evaluation is likely to continue and (2) speculate about how benefits may be measured and valued to inform economic evaluation in the future. Evidence supports the use of the EQ-5D in many areas of health, but there are notable gaps. Furthermore, there has been interest among some policy makers in measuring changes in well-being, and in using common outcomes across sectors. Possibilities for measuring well-being alongside health can be achieved through bolt-on dimensions or an entirely new measure capturing both health and well-being. Nevertheless, there are significant concerns about the logic of estimating a common utility function. The development of online valuation methods has had a major impact on the field, which is likely to continue. We, however, recommend more allowance for respondents to consider their answers. There is an ongoing debate on the role of patient values or experience-based values. To date, this has seen limited take-up by decision makers and there are significant technical problems to obtaining representative and meaningful values. Policy makers and the general population must decide on the focus and scope of benefits that are incorporated into economic evaluation, and current evidence on this is mixed. In part, this will determine whether the widespread adoption will continue.
•There is widespread adoption of the EuroQol 5-dimensional questionnaire and its corresponding time trade-off–based value sets to inform economic evaluation.•This article considers whether this widespread adoption is likely to continue by considering recent developments in assessing the benefits of healthcare to move beyond health to include nonhealth aspects, and recent developments in health state valuation.•The article recommends that policy makers and the general population must ultimately make a judgment around the focus and scope of benefits that are incorporated into economic evaluation, and in part this will determine whether the widespread adoption will continue.
Isolates from patients with Clostridium difficile infection (CDI) usually produce both toxin A (TcdA) and toxin B (TcdB), but an increasing number of reports from Europe and Asia mention infections ...with TcdA-negative, TcdB-positive (A–/B+) strains, usually characterized as PCR ribotype 017 (type 017). Incidence rates of CDI per 10 000 admissions in a 200-bed Argentinean general hospital were 37, 84, 67, 43, 48 and 42 for the years 2000 to 2005, respectively. The annual percentages of type 017 CDI were 7.7%, 64.6%, 91.4%, 92.0%, 75.0% and 86.4%, respectively. Comparison of 112 017-CDI patients with 41 non-017-CDI patients revealed that 017-CDI patients were more often male (68.8% vs. 46.3%; odds ratio 2.55, 95% confidence interval 1.23–5.50). All type 017 strains tested belonged to toxinotype VIII and had a 1.8-kb deletion in tcdA. In addition, 90% of tested type 017 isolates had high-level resistance to clindamycin and erythromycin, determined by the presence of the ermB gene. Multiple-locus variable-number tandem-repeat analysis (MLVA) was applied to 56 Argentinean isolates and 15 isolates from seven other countries. Country-specific clonal complexes were found in each country. Among 56 Argentinean isolates, four clonal complexes were recognized, accounting for 61% of all isolates. These clonal complexes did not show correlation over time, but seemed to be restricted to specific wards, mainly internal medicine and pulmonology wards. A total of 56% of recurrent infections were caused by a different isolate, despite identification of an identical PCR-ribotype. We conclude that C. difficile type 017 gradually replaced other circulating PCR ribotypes and that MLVA provides detailed insight into nosocomial spread.
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