Multivariate Meta-Analysis of Preference-Based Quality of Life Values in Coronary Heart Disease

Background

There are numerous health-related quality of life (HRQol) measurements used in coronary heart disease (CHD) in the literature. However, only values assessed with preference-based instruments can be directly applied in a cost-utility analysis (CUA).

Objective

To summarize and synthesize instrument-specific preference-based values in CHD and the underlying disease-subgroups, stable angina and post-acute coronary syndrome (post-ACS), for developed countries, while accounting for study-level characteristics, and within- and between-study correlation.

Methods

A systematic review was conducted to identify studies reporting preference-based values in CHD. A multivariate meta-analysis was applied to synthesize the HRQoL values. Meta-regression analyses examined the effect of study level covariates age, publication year, prevalence of diabetes and gender.

Results

A total of 40 studies providing preference-based values were detected. Synthesized estimates of HRQoL in post-ACS ranged from 0.64 (Quality of Well-Being) to 0.92 (EuroQol European”tariff”), while in stable angina they ranged from 0.64 (Short form 6D) to 0.89 (Standard Gamble). Similar findings were observed in estimates applying to general CHD. No significant improvement in model fit was found after adjusting for study-level covariates. Large between-study heterogeneity was observed in all the models investigated.

Conclusions

The main finding of our study is the presence of large heterogeneity both within and between instrument-specific HRQoL values. Current economic models in CHD ignore this between-study heterogeneity. Multivariate meta-analysis can quantify this heterogeneity and offers the means for uncertainty around HRQoL values to be translated to uncertainty in CUAs.     

RNase and DNase activities in the alfalfa and lentil grown in iso-osmotic solutions of NaCl and mannitol

Nucleolytic activities from two plants of Leguminosae family were determined in order to consider if the nucleases of plants which belong to the same family or to the same species responded in similar ways to stress conditions during growth. Growth parameters of both plants were examined in parallel. In detail, seedlings from two plants, alfalfa (Medicago sativa L. cv. Luzerne Euver) and lentil (Lens culinaris cv. Thessalia), showed significant differences in response to iso-osmotic solutions of NaCl (100 mmol · L⁻¹ solution equivalent to conductivity 8.0 dS m⁻¹) and mannitol (190 mmol · kg⁻¹). Plant height and dry weight of mannitol/NaCl-treated seeds in both plants were lower in comparison to controls (water). Mannitol stress reduced height and dry weight in alfalfa seedlings more than did NaCl. By contrast, lentil seedling growth was inhibited more by NaCl stress than mannitol. In addition, DNase and RNase response to mannitol stress differed in each plant compared to the controls. Mannitol stress induced a sharp increase in DNase- and RNase-specific activity during the initial stages of alfalfa seedlings' growth, followed by a decrease during subsequent days; in lentil seedlings, these activities were inhibited throughout the entire growth period. NaCl stress inhibited the above activities in both plants. After native electrophoresis on gels polymerized in the presence of DNA/RNA, the overall band intensities confirmed the above quantitative results of alfalfa RNase and DNase activity. In addition, the active gel analysis revealed that the decrease of nucleolytic activities in mannitol-treated alfalfa seedlings was mainly due to the strong reduction of acid nucleases. This is the first report of different non-ionic osmotic response of type I plant nucleases during seedlings' growth. In vitro, the addition of up to 300 mmol/L mannitol did not affect acid and neutral nuclease activity in enzyme preparations extracted, purified, and separated from control and mannitol-treated alfalfa seedlings.Our results suggest that plant nucleases responded in a different way to osmotic stress and ionic stress conditions during seedlings' growth.     

Sexual transmission of SIVagm in wild grivet monkeys

This study reports the prevalence of simian immunodeficiency virus and the relationship of serostatus to age and sex among a wild population of Ethiopian grivet monkeys (Cercopithecus aethiops aethiops). Seropositivity paralleled patterns of sexual activity, being nearly universal in females of reproductive age, and absent in all males except those that were fully adult. One female seroconverted between two capture seasons at an age consistent with first breeding. Our findings support a predominantly sexual mode of transmission among SIV_agm infected grivets.     

Issues in Human Particulate Exposure Assessment: Relationship between Outdoor,Indoor, and Personal Exposures

The recent review of the National Ambient Air Quality Standard for particuslate matter and the resultant new health-based PM_2.5 standard was in part motivated by findings from epidemiological studies. These studies reported significant associations between adverse health effects and concentrations of ambient particulate matter at levels below the previously existing PM₁₀ standard. Interpretation of these results has been hindered by our relatively poor understanding of the relationship between personal exposures and concentrations in the indoor and outdoor environments. Individuals spend the majority of their time in indoor environments. Therefore, it is important to understand where and how they may be exposed to the contaminants which may be causing the health effects, and which activities place them at a higher risk of exposure to these agents. In addition, since particulate matter is a complex mixture of contaminants, further research is required to examine its formation process, sources, composition, and health effects. Without an improved scientific understanding of these issues, it is difficult to assess whether the new PM_2.5 standard will be implemented, and if so, whether it can be adequately protective of public health.     

Effects of DDAVP on gender-specific verbal and visuospatial tasks in healthy young adults

Although several studies have demonstrated the efficacy of the vasopressin analog DDAVP in enhancing human cognition, few previous studies have explored possible interactions of treatment with DDAVP and gender in healthy young adults. The present study was undertaken to explore the effects of treatment with DDAVP on gender-specific tasks. Male and female volunteers were treated with either DDAVP or saline and asked to recall lists of words and to perform the Paper Folding and Stroop Color Word Tests. Although treatment with DDAVP produced few effects in these tasks, the effects that were noted involved impairment of performance.     

Application of Anodic Stripping Voltammetry for Zinc, Copper, and Cadmium Quantification in the Aqueous Humor: Implications of Pseudoexfoliation Syndrome

Anodic stripping voltammetric (ASV) procedure, using mercury film electrode, was optimized and applied to determine the concentrations of zinc, cadmium, and copper in the aqueous humor. Concentration levels as low as 1 ppb of the test metals was possible to be detected using short electrolysis times (120 s) and microquantities of aqueous humor (up to 35 μL). As a first application of the voltammetric analysis of trace metals in the aqueous humor, the role of the three selected trace elements in the pseudoexfoliation (PEX) syndrome was examined. Samples from aqueous humor were collected during cataract extraction from patients with and without PEX. The zinc and copper concentration levels in the aqueous humor did not show statistically significant difference in the study and control group. Cadmium was detected in a small number of samples, without however statistical differences between the two groups. ASV proved to be a highly precise and sensitive tool for the quantification of heavy metal ions in aqueous humor. Further studies may lead to useful conclusions for the role of zinc, copper, or cadmium in PEX syndrome.     

Predicting <Emphasis Type="Italic">β</Emphasis>-turns and their types using predicted backbone dihedral angles and secondary structures

Background  

β-turns are secondary structure elements usually classified as coil. Their prediction is important, because of their role in protein folding and their frequent occurrence in protein chains.