Baseline Quality-of-Life of Caregivers of Patients With Heart Failure Prior to Advanced Therapies: Findings From the Sustaining Quality of Life of the Aged: Transplant or Mechanical Support (SUSTAIN-IT) Study.

BACKGROUND: We compared health-related quality of life (HRQOL), depressive symptoms, anxiety, and burden in caregivers of older patients with heart failure based on the intended therapy goal of the patient: awaiting heart transplantation (HT) with or without mechanical circulatory support (MCS) or prior to long-term MCS; and we identified factors associated with HRQOL. METHODS: Caregivers (n = 281) recruited from 13 HT and MCS programs in the United States completed measures of HRQOL (EQ-5D-3L), depressive symptoms (PHQ-8), anxiety (STAI-state), and burden (Oberst Caregiving Burden Scale). Analyses included ANOVA, Kruskal-Wallis tests, χ2 tests, and linear regression. RESULTS: The majority of caregivers were female, white spouses with ≤ 2 comorbidities, median [Q1,Q3] age = 62 [57.8, 67.0] years. Caregivers (HT with MCS = 87, HT without MCS = 98, long-term MCS = 96) reported similarly high baseline HRQOL (EQ-5D-3L visual analog scale median score = 90; P = 0.67 for all groups) and low levels of depressive symptoms. STAI-state median scores were higher in the long-term MCS group vs the HT groups with and without MCS, (38 vs 32 vs 31; P < 0.001), respectively. Burden (task: time spent/difficulty) differed significantly among groups. Caregiver factors (number of comorbidities, diabetes and higher anxiety levels) were significantly associated with worse caregiver HRQOL, R2 = 26%. CONCLUSIONS: Recognizing caregiver-specific factors, including comorbidities and anxiety, associated with the HRQOL of caregivers of these older patients with advanced HF may guide support strategies.

A laboratory technique for thermal emission measurement of hydrated minerals.

Laboratory emission spectra are measured at Arizona State University's Mars Space Flight Facility for comparison to remotely sensed data from Earth and Mars. Such emission spectroscopy using an interferometric spectrometer measures the energy of the sample, including reflected and emitted background sources. The detector is uncooled at ambient temperature, which produces a very low signal when measuring the energy from a sample that has a temperature close to its own. In order to increase the energy difference between the sample and the detector, thereby increasing the signal received by the detector, samples are typically heated to between 60 and 80 degrees C for several hours prior to measurement. While this method is acceptable for most rock and mineral samples, some hydrous minerals dehydrate quickly at low relative humidity and temperatures above room temperature. This change is evident in both the physical appearance of the mineral and in the position and shape of its spectral absorptions. One solution to this problem is to heat samples to lower temperatures (e.g., 40 degrees C) for only a short time period. However, this approach results in a low signal from the sample and does not always avoid dehydration. For this reason, we have developed a technique for measuring and calibrating emission spectra of hydrated minerals that involves cooling samples to well below the temperature of the detector, which avoids dehydration, while creating a large delta temperature and a strong signal from the sample. Our method allows for accurate library spectra, with discrete, pronounced spectral features (high spectral contrast), of hydrated minerals that can be used for comparison to planetary surfaces.

Chloride-bearing materials in the southern highlands of Mars.

Chlorides commonly precipitate during the evaporation of surface water or groundwater and during volcanic outgassing. Spectrally distinct surface deposits consistent with chloride-bearing materials have been identified and mapped using data from the 2001 Mars Odyssey Thermal Emission Imaging System. These deposits are found throughout regions of low albedo in the southern highlands of Mars. Geomorphologic evidence from orbiting imagery reveals these deposits to be light-toned relative to their surroundings and to be polygonally fractured. The deposits are small (< approximately 25 km(2)) but globally widespread, occurring in middle to late Noachian terrains with a few occurrences in early Hesperian terrains. The identification of chlorides in the ancient southern highlands suggests that near-surface water was available and widespread in early Martian history.

Idiopathic steatohepatitis in childhood: a multicenter retrospective study.

OBJECTIVE: To describe the clinical, laboratory, and histopathologic features of idiopathic steatohepatitis in children. STUDY DESIGN: Retrospective review of all liver biopsies performed at Boston Children's Hospital, Massachusetts General Hospital, and the University of Massachusetts Medical Center from 1991 to 1994. Chart review was performed when biopsies demonstrated steatosis. RESULTS: Eighty-two patients had biopsy-proven hepatic steatosis. Fourteen patients had fatty liver without evidence of inherited, infectious, autoimmune, endocrinologic, toxicologic, or iatrogenic causes. All 14 patients were obese, averaging 159% of ideal body weight (range, 121% to 222%). Nine patients initially had transient abdominal pain, two had hepatomegaly, and one was identified by incidental laboratory evaluation. These 12 patients had biopsies because of persistent elevations of aminotransferase levels. Two other patients without risk factors for steatosis were identified at staging laparotomy for Hodgkin lymphoma. The 10 boys and 4 girls had an average age of 13.5 years (range, 10 to 18 years). Aminotransferase elevations were modest, with aspartate aminotransferase and alanine aminotransferase values averaging 77 +/- 38 IU and 129 +/- 73 IU, respectively. All had imaging studies demonstrating diffuse fatty change. Histologic examination of biopsy specimens revealed varying degrees of steatosis with inflammation and fibrosis. CONCLUSION: Idiopathic steatohepatitis occurs predominantly or exclusively in obese peripubertal children. This entity represents a frequent reason for liver biopsy in this age group. The degree of steatosis, fibrosis, and inflammation does not correlate with symptoms or signs, and significant liver injury with bridging fibrosis may be present.

Adaptation of the MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) assay for the determination of virus-neutralizing antibodies using the virus-neutralization assay.

The tetrazolium salt MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide] has been widely used for bioassays. Herein is described the use of the MTT dye with a virus-neutralization (VN) assay to titer infectious bursal disease virus (IBDV)-neutralizing antibodies. A standard VN assay using chicken embryo fibroblasts (CEFs) and IBDV was used for the assessment of IBDV-neutralizing antibodies. The percent of CEF killing due to IBDV was quantitated using MTT, and the absorbance (A) data were used to calculate the VN antibody titer. This method of calculation offers the expression of VN titer in terms of units of activity per unit of volume.