105,176 research outputs found
Adrenomedullin refines mortality prediction by the BODE index in COPD - The "BODE-A" index.
No full textpeer reviewedThe BODE index is well-validated for mortality prediction in COPD. Concentrations of plasma proadrenomedullin, a surrogate for mature adrenomedullin, independently predicted 2-year mortality among inpatients with COPD exacerbation.We compared accuracy of initial proadrenomedullin level, BODE, and BODE components, alone or combined, in predicting 1-year or 2-year all-cause mortality in a multicenter, multinational observational cohort with stable, moderate to very severe COPD.Proadrenomedullin was significantly associated (P<0.001) with 1-year mortality (4.7%) and 2-year mortality (7.8%), and comparably predictive to BODE regarding both (C statistics: 0.691 vs. 0.745, 0.635 vs. 0.679). Relative to using BODE alone, adding proadrenomedullin significantly improved 1-year and 2-year mortality prognostication (C statistics: 0.750, 0.818; both P<0.001). Proadrenomedullin plus BOD was more predictive than was the original BODE including 6-minute-walk distance. In multivariable analysis, proadrenomedullin (LR X2 13.0, P<0.001), body mass index (8.5, P=0.004), and 6-minute-walk distance (7.5, P=0.006), but not modified MMRC dyspnoea score (2.2, P=0.14) or FEV1 % predicted (0.3, P=0.60), independently foretold 2-year survival.Proadrenomedullin plus BODE better predicts mortality in COPD patients than does BODE alone; proadrenomedullin may substitute for 6-minute-walk distance in BODE when 6-minute-walk testing is unavailable
Relationship between oxygen consumption kinetics and BODE Index in COPD patients
No full textAudrey Borghi-Silva,1 Thomas Beltrame,1,2 Michel Silva Reis,1 Luciana Maria Malos&aacute; Sampaio,3 Aparecida Maria Catai,1 Ross Arena,4 Dirceu Costa31Cardiopulmonary Physiotherapy Laboratory, Nucleus of Research in Physical Exercise, Federal University of S&atilde;o Carlos, S&atilde;o Carlos, SP, Brazil; 2Faculty of Applied Health Sciences, University of Waterloo, Waterloo, ON, Canada; 3Rehabilitation Sciences Master&rsquo;s Program, Universidade Nove de Julho, Sao Paulo, SP, Brazil; 4Division of Physical Therapy, Department of Orthopedics, Division of Cardiology, Department of Internal Medicine, and Latin American and Iberian Institute, University of New Mexico, Albuquerque, NM, USABackground and objective: Patients with chronic obstructive pulmonary disease (COPD) present with reduced exercise capacity due to impaired oxygen consumption (VO2), caused primarily by pulmonary dysfunction and deleterious peripheral adaptations. Assuming that COPD patients present with slower VO2 and heart rate (HR) on-kinetics, we hypothesized that this finding is related to disease severity as measured by the BODE Index. In this context, the present study intends to evaluate the relationship between VO2 uptake on-kinetics during high-intensity exercise and the BODE Index in patients with COPD.Methods: Twenty males with moderate-to-severe stable COPD and 13 healthy control subjects matched by age and sex were evaluated. COPD patients were screened by the BODE Index and then underwent an incremental cardiopulmonary exercise test and a constant speed treadmill session at 70% of maximal intensity for 6 minutes. The onset of the exercise (first 360 seconds) response for O2 uptake and HR was modeled according to a monoexponential fit.Results: Oxygen consumption and HR on-kinetics were slower in the COPD group compared with controls. Additionally, VO2 on-kinetic parameters revealed a strong positive correlation (r = 0.77, P &lt; 0.05) with BODE scores and a moderate negative correlation with walking distance (r = &minus;0.45, P &lt; 0.05).Conclusion: Our data show that moderate-to-severe COPD is related to impaired oxygen delivery and utilization during the onset of intense exercise.Keywords: COPD, VO2 on-kinetics, heart rate, BODE Inde
Myocardial performance index correlates with the BODE index and affects quality of life in COPD patients
No full textDaniela Graner Schuwartz Tannus-Silva,1 João Batista Masson-Silva,1 Lays Silva Ribeiro,1 Marcus Barreto Conde,2,3 Marcelo Fouad Rabahi1 1Faculty of Medicine, Federal University of Goias, Goiânia, Goiás, 2Instituto de Doenças do Tórax da Universidade Federal do Rio de Janeiro, Rio de Janeiro, 3Faculdade de Medicina de Petrópolis, Petrópolis, Rio de Janeiro, Brazil Background and objective: COPD, a systemic illness associated with the impairment of different organs, affects patient prognosis and quality of life. The aim of this study was to evaluate the association between right ventricle (RV) function, the BODE (body mass index, airflow obstruction, dyspnea, and exercise capacity) index (a multifunctional scale for the assessment of mortality risk), and quality of life in patients with COPD. Methods: A cross-sectional study was carried out in 107 outpatients presenting with stable COPD who underwent clinical assessment, spirometry, arterial blood gas analyses, a 6-minute walk test, electrocardiography, and echocardiogram and who responded to the Saint George’s Respiratory Questionnaire (SGRQ). Results: Among the study subjects, 53% (57/107) were males, and the mean age was 65.26±8.81 years. A positive correlation was observed between RV dysfunction measured by the myocardial performance index using tissue Doppler (MPIt) and the BODE index, even after adjustment for age and partial pressure of oxygen (r2=0.47; P<0.01). Patients with alterations in the MPIt had worse quality of life, and a statistically significant difference was found for different domains of the SGRQ. Patients with a normal MPIt had a mean total score of 46.2±18.6, whereas for those with MPIt alterations, the mean total score was 61.6±14.2 (P=0.005). These patients had a 1.49-fold increased risk of exhibiting SGRQ total score above the upper limit of the 95% CI (P=0.01). Conclusion: The findings of this study suggest that RV dysfunction as measured by the MPIt was associated with impairment in quality of life and a worse BODE index in COPD patients, irrespective of age and hypoxemia status. Keywords: COPD, right ventricle dysfunction, echocardiography, BODE score, quality of lif
Letter, [Author unclear] to Paulina T. Merritt
No full textHandwritten letter to Paulina Merritt from an unknown author, October 1, 1876.
Strategies for synthesis of yardsticks and abaci for nanometre distance measurements by pulsed EPR
No full textSilvia Valera is grateful for support by EPSRC and Bela E. Bode acknowledges support by EastCHEM.Pulsed electron paramagnetic resonance (EPR) techniques have been found to be an efficient tool for elucidation of structure in complex biological systems as they give access to distances in the nanometre range. These measurements can provide additional structural information such as relative orientations, structural flexibility or aggregation states. A wide variety of model systems for calibration and optimisation of pulsed experiments has been synthesised. Their design is based on mimicking biological systems or materials in specific properties such as the distances themselves and the distance distributions. Here, we review selected approaches to the synthesis of chemical systems bearing two or more spin centres, such as nitroxide or trityl radicals, metal ions or combinations thereof and sketch their application in pulsed EPR distance measurements.Peer reviewe
Interviews with Carl T. Bode, Isabelle Fritschen, Joseph H. Hirt, Mary G. Hirt, and Minnie Campbell
No full textInterviews with Carl T. Bode, Isabelle Fritschen, Joseph H. Hirt, Mary G. Hirt, and Minnie Campbell. The recording includes a variety of German-language songs. The last half of the recording is dedicated to Minnie Campbell telling about her time working for Mother Bickerdyke. The first few minutes of the recording are missing. 00:00:13 - Song, The Messenger Bird sung by Joseph H. Hirt and translated by Isabelle Fritschen 00:01:35 - Song, Birdie in the Window, sung by Mary Gertrude Hirt 00:02:59 - Story of Peter John Thielen\u27s experience in the Franco-Prussian War told by Joseph Hirt 00:05:27 - Grandfather\u27s experience with wild cattle told by Isabelle Fritschen 00:07:31 - Carl T. Bode introduction 00:08:46 - Nursery rhyme about hands 00:09:09 - The Cuckoo and the Donkey 00:09:42 - Sleep Baby Sleep 00:10:24 - Golden Evening Sun 00:11:00 - Beautiful Moon 00:12:10 - My Homeland 00:13:50 - Minnie Campbell Introduction 00:14:05 - Experiences as Mother Bickerdyke\u27s secretary 00:14:35 - Mother Bickerdyke\u27s 81st birthday celebration in Bunker Hill, KS 00:19:59 - Mother Bickerdyke\u27s portrait 00:23:55 - How Lydia Foster, Mother Bickerdyke\u27s Black maid came to live with her. 00:26:34 - Mother Bickerdyke\u27s death 00:29:34 - Mother Bickerdyke\u27s burial in Galesburg, Illinois 00:30:28 - Working for Mother Bickerdyke 00:34:01 - Going to School as a student of James Bickerdyke, Mother Bickerdyke\u27s son 00:35:26 - Decline of Bunker Hill, KS 00:37:15 - Russell stealing the county seat from Bunker Hill 00:38:09 - Closing of the Dorrance, KS bank 00:39:00 - Mother Bickerdyke\u27s personality 00:42:34 - Experience with Nina Brown Baker author of Cyclone in Calico 00:48:24 - Mother Bickerdyke Home for Widows and Children in Ellsworth, KS 00:51:13 - Post scripthttps://scholars.fhsu.edu/sackett/1014/thumbnail.jp
Fast Identification of Bound Structures in Large N-body Simulations
No full textWe present an algorithm that is designed to allow the efficient identification and preliminary dynamical analysis of thousands of structures and substructures in large N-body simulations. First, we utilize a refined density gradient system (based on denmax) to identify the structures and then apply an iterative approximate method to identify unbound particles, allowing fast calculation of bound substructures. After producing a catalogue of separate energetically bound substructures, we check to see which of these are energetically bound to adjacent substructures. For such bound complex subhaloes, we combine components and check if additional free particles are also bound to the union, repeating the process iteratively until no further changes are found. Thus, our subhaloes can contain more than one density maximum, but the scheme is stable: starting with a small smoothing length initially produces small structures that must be combined later and starting with a large smoothing length produces large structures within which sub-substructure is found. We apply this algorithm to three simulations. Two that are using the TPM algorithm by Bode, Ostriker & Xu and one on a simulated halo by Diemand, Moore & Stadel. For all these haloes, we find about 5–8 per cent of the mass in substructures
Die Praktikabilität des BODE-Index bei schwer exazerbierten COPD-Patienten
No full textDie COPD zählt zu den häufigsten Erkrankungen weltweit, deren Morbidität und Mortalität weiter ansteigen. Sie wird definiert als eine chronische, nicht vollständig reversible Atemwegsobstruktion, gemessen anhand der Einsekundenkapazität (FEV1) und der Vitalkapazität (VC). Mittels dieser Parameter kann der Schweregrad nach der GOLD-Klassifikation festgelegt werden.Studien beweisen zunehmend, dass die COPD nicht nur eine Lungen-, sondern auch eine Systemerkrankung ist. Betroffen werden das kardiovaskuläre und muskuloskelettale System. Hinzu kommen eine systemisch nachweisbare Inflammation und depressive Symptome. Diesen Erkenntnissen Rechnung tragend wurde der BODE-Index entwickelt. Er setzt sich aus dem Body-Mass-Index (BMI), der Obstruktion (FEV1), dem Dyspnoegrad (MMRC-Dyspnoe-Skala) und der Exercise Capacity (6-Min-Gehtest) zusammen und gilt als besserer Prädiktor der Mortalität als die FEV1 alleine. Zudem korreliert er mit der Lebensqualität und der Exazerbationsfrequenz. In allen bisher publizierten Arbeiten wurde sein Vorhersagewert jedoch nur an klinisch stabilen Patienten untersucht.Die vorliegende Arbeit sollte dazu dienen, die Praktikabilität des BODE-Index bei schwer exazerbierten COPD-Patienten im stationären Bereich zu evaluieren sowie seine Korrelationen mit Liegezeit, Indikation zur Sauerstofftherapie, Glukokortikoiddosis und Exazerbationsfrequenz zu untersuchen.Dazu wurden 218 exazerbierte COPD-Patienten rekrutiert. Von diesen 218 Patienten konnte bei 42 der BODE-Index erhoben werden das Kollektiv mit BODE-Index. Bei 139 Patienten kamen Ausschlusskriterien zum Tragen, so dass der BODE- Index nicht bestimmt werden konnte das Kollektiv ohne BODE-Index. Dabei führte der 6-Min-Gehtest am häufigsten zum Ausschluss, denn er konnte bei 80% der Patienten des Kollektivs ohne BODE-Index aufgrund des schlechten Allgemeinbefindens, der Dyspnoe oder muskulärer Schwäche nicht durchgeführt werden. 39 Patienten schieden wegen einer unvollständigen Datenlage aus.Beide Kollektive unterschieden sich weder im Altersdurchschnitt noch in der Geschlechterverteilung. Jedoch hatte das Kollektiv mit BODE-Index eine um durchschnittlich zwei Tage kürzere Liegezeit (p = 0,048; Mann-Whitney-U-Test), und es bestand deutlich seltener die Indikation zur passageren und zur Sauerstofflangzeittherapie (p = 0,005; Chi2-Test nach Pearson). Alle Patienten, bei denen der BODE-Index nicht erhoben werden konnte (Kollektiv ohne BODE-Index), waren somit schwerer erkrankt als die Patienten, bei denen es möglich war den BODE-Index zu berechnen (Kollektiv mit BODE-Index).Der BODE-Index verbesserte sich unter der stationären Therapie um 1,1 Punkte (p = 0,001; t-Test für abhängige Stichproben). Die Untersuchung der Korrelationen zwischen BODE-Index und Liegezeit, Indikation zur Sauerstofftherapie und Glukokortikoiddosis ergab, dass nur zwischen BODE-Index und Liegezeit ein statistisch signifikanter Zusammenhang bestand (p = 0,013, Chi2-Test nach Pearson). Für alle anderen Variablen konnte keine Korrelation nachgewiesen werden. Insbesondere korreliert der BODE-Index, erhoben an schwer exazerbierten Patienten, nicht mit der Exazerbationsfrequenz.Durch die vorliegende Arbeit wurde festgestellt, dass der BODE-Index für den Alltag in einem Akutkrankenhaus unbrauchbar ist, da schwergradig exazerbierte Patienten häufig nicht in der Lage sind, alle für den BODE-Index notwendigen Untersuchungen zu durchlaufen. Dabei ergab sich die größte Einschränkung durch den 6-Min-Gehtest.Aufgrund dieses Resultates ist es für zukünftige Studien von besonderem Interesse zu überprüfen, welche Parameter den 6-Min-Gehtest im BODE-Index ersetzen könnten, damit der so modifizierte BODE-Index auch bei schwer exazerbierten COPD-Patienten Anwendung finden kann.Background: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality throughout the world. It is a slowly progressive disorder characterized by airflow obstruction, which is not fully reversible. The GOLD-Classification graduates the COPD in four stages of severity with the help of the post-bronchodilator forced expiratory volume in one second (FEV1) and clinical symptoms.A large number of clinical trials show that COPD patients also have systemic manifestations like cardiac comorbidities, musculoskeletal dysfunction, depression and systemic inflammation that are not reflected by the FEV1. To perceive the COPD as a systemic disease the BODE-Index, a multidimensional grading system, was developed. The BODE index, which comprises body mass index, airflow limitation (FEV1), dyspnea and 6-min-walk-distance, predicts mortality in collectives of patients with COPD. It correlates with quality of life and the frequency of exacerbation as well.Objectives: Up to now the predictive value of the BODE-Index was only shown for clinically stable patients. Aim of our study was to investigate the BODE-Index regarding severely exacerbated COPD-patients and to evaluate the relationship between BODE-Index and length of stay, oxygen therapy, application of steroids and frequency of exacerbation.Methods: 218 exacerbated COPD-patients were recruited from a pneumological clinic. We assessed the BODE-Index of 42 patients. 139 patients were not able to accomplish all parts of the BODE-Index-examinations. Hence we had two groups of patients, one collective with, another without BODE-Index. Both groups were compared concerning age, gender, indication for oxygen-therapy and treatment with steroids as well as length of stay.The BODE-Index was correlated with the indication for oxygen- and steroid-application, the length of stay and the frequency of exacerbation within 6 months after discharge.Results: With regards to the collective without BODE-Index it became apparent that the 6-min-walk-test was a main exclusion criterion. According to the COPD severity 80% out of 139 patients could not undergo the 6-min-walk-test.By comparing both collectives it could be shown, that they did not differ in gender or age. But the collective with BODE-Index needed oxygen less often (p = 0,005; Chi2-Test according to Pearson) and had on average a two days shorter length of stay (p = 0,048; Mann-Whitney-U-Test).With regards to the collective with BODE-Index a positive correlation could only be found for the BODE-Index with length of stay (p = 0,013; Chi2-Test according to Pearson). The BODE-Index did not correlate with the indication for oxygen therapy, the need for steroids or the exacerbation frequency. In particular the BODE-Index did not correlate with the exacerbation frequency in severe exacerbated patients.During hospitalization the BODE-Index improved by 1.1 points (p = 0,001; paired t-test).Conclusions: Our study has shown that the BODE-Index is not applicable for in-patients with severe COPD, because most patients in this stage are not able to undergo the 6-min-walk-test. Therefore it is of note for intended studies to develop a modified BODE-Index that replaces the 6-min-walk-test. Thus the predictive value of the BODE-Index could be expanded to include all patients, irrespective of COPD severity
Singular value bode diagram of the closed-loop transfer function <i>T</i><sub>2</sub>.
No full textSingular value bode diagram of the closed-loop transfer function T2.</p
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