Detailed Assessment Research Articles

Gitelman Syndrome in a 37-Years Old Woman with Urinary Tract Syndrome and History of Caesarean Section: A Case Report

Gitelman Syndrome (GS) is a rare genetic disorder often underdiagnosed due to its non-specific symptoms that can appear from neonatal stages to adulthood. It is more frequently observed in Asians, with a prevalence of approximately 1 in 40,000 people. Accurate diagnosis requires a comprehensive clinical interview and laboratory examinations. This report presents the case of a 37-year-old woman with GS who also experienced a urinary tract infection and had a history of cesarean section. Upon admission, she reported feeling fatigued and weak in all extremities. She had undergone a cesarean section a month prior due to pre-eclampsia. Initial laboratory tests revealed hypokalaemia, hyponatremia, and hypochloraemia. Further evaluation during hospitalization detected a urinary tract infection, hypocalciuria, and hypomagnesemia. The patient also suffered from carpopedal spasms and muscle cramps. Treatment included magnesium sulfate, calcium gluconate, potassium chloride, and sodium chloride infusions to restore electrolyte balance. The patient was discharged after six days, with a diagnosis of Gitelman Syndrome, which was unusual given her late onset of symptoms, as most cases are identified in childhood. The clinical presentation was largely driven by the patient’s electrolyte imbalances, especially hypokalaemia and hypomagnesemia, with hypomagnesemia further contributing to hypocalcemia and vitamin D deficiency. The patient’s symptoms improved after appropriate electrolyte supplementation. This case emphasizes the importance of a detailed clinical history and laboratory assessments in diagnosing GS, along with timely correction of electrolyte disturbances to improve the patient’s condition and prevent complications.

Ecological niche assessment and conservation status of colocolo pampas cat Leopardus colocola (Molina 1782)

Until 2021, Leopardus colocola was considered a species distributed across much of South America. However, recent studies have shown that it is a monotypic species, apparently restricted in its distribution to the central-northern region of Chile, distinct from other felines of the same genus. This change in its classification and distribution has sparked debate regarding its conservation status, which now requires a detailed assessment. In this study, we analyzed the species’ geographic distribution using ecological niche modeling and evaluated its conservation status according to the guidelines of the International Union for Conservation of Nature, considering the impact of mining concessions and Chile's road network. Presence records of the species were systematized, and a new ecological niche model was developed. Additionally, the Extent of Occurrence (EOO) and the Area of Occupancy (AOO) were calculated. The fragmentation and projected reduction of the niche model, along with the EOO and AOO, place the species under the Criteria B2ab (i, ii, iii), leading to its classification as “Endangered.” This study provides an updated view of the species' geographic distribution and conservation status in Chile. The results are crucial for future conservation efforts and offer a solid foundation for effective management strategies.

Assessing Irrigation Efficiency Improvements in Paddy Fields Using Granular SWMM Simulations

As water scarcity intensifies due to climate change, improving the efficiency of agricultural water use has become increasingly critical. Current irrigation systems often experience significant water losses, especially in paddy fields in South Korea that largely rely on open-channel water supply networks. However, previous studies have simulated irrigation improvement strategies by aggregating multiple paddy fields into larger unites rather than modeling them individually, which limits the accurate representation of field conditions. To address this limitation, we applied a granular simulation approach, collecting detailed input data through field surveys. Using this granular model, the study evaluated strategies to enhance irrigation efficiency in paddy fields serviced by the Baekma Agricultural Reservoir in South Korea. We assessed four scenarios: the current open-channel system, conversion of open channels to closed conduits, installation of farm ponds, and a combination of closed conduits and farm ponds. These scenarios were simulated using the Strom Water Management Model (SWMM), meticulously configured to represent individual paddy fields and channel networks. The results show that converting open channels to closed conduits increased irrigation efficiency by 5.4% compared to the current open-channel system. Combining closed conduits with farm ponds achieved the highest efficiency, although the independent effect of farm ponds was minimal. These findings suggested that converting open-channels to closed conduits was a highly effective solution for reducing water losses, while farm ponds played a limited role. This study provides valuable insights into the development of precise irrigation strategies, offering a detailed assessment of real-world conditions in paddy fields.

Differentiation of Suspected Methanol Poisoning From Ethanol Poisoning: A Review Study and Consensus Statement

Background: Ethanol and methanol poisoning pose significant clinical challenges due to their overlapping clinical presentations. This literature review and consensus statement aim to provide evidence-based guidelines for differentiating these two poisonings.Methods: We conducted a comprehensive literature review of relevant literature, including individual patient data (IPD) meta-analysis, to assess clinical, laboratory, and diagnostic findings in cases with ethanol and methanol poisoning. A literature review was also performed to gather case series of electrocardiograms of ethanol and methanol poisoning. We synthesized the evidence and convened an expert panel to develop consensus-based recommendations.Results: Based on the literature review and IPD analysis, cases of methanol poisoning often present later than 24 hours after alcohol consumption, emphasizing the importance of assessing patients with delayed referrals. Methanol-poisoned patients are frequently awake and responsive after 12 hours of ingestion, but symptoms alone do not reliably differentiate between the two poisonings. Declines in visual acuity and symptoms are strongly associated with methanol poisoning and should prompt immediate hospitalization and ophthalmic examination. Oliguria and anuria are more common in cases of methanol poisoning, warranting detailed urinary symptom assessment and close monitoring of urinary output. Electrocardiograms are essential for all alcohol poisoning patients, with non-sinus rhythm suggesting methanol poisoning. Arterial blood gas analysis, with low pH values, favors methanol poisoning. However, blood sugar levels alone cannot definitively determine the type of poisoning. Laboratory point-of-care tests to diagnose methanol in serum are urgently needed.Conclusion: This literature review and consensus statement offer guidance for healthcare providers facing cases of alcohol poisoning where point-of-care testing methods of blood alcohol concentrations are unavailable. A comprehensive assessment, considering clinical history, physical examination, laboratory data, and specialized evaluations such as ophthalmic examination and electrocardiograms, is essential for accurately differentiating ethanol and methanol poisoning.

Gullian Barre syndrome secondary to heat stroke: a case report.

Heat waves are increasingly common in subcontinent countries, including Pakistan. Heat stroke (HS) is a critical condition resulting from extreme temperatures, often culminating in multiorgan dysfunction. Clinical manifestations of heat-related emergencies can include altered mentation, fever, and profound weakness. We present a compelling case of a previously healthy 49-year-old male who developed altered mentation, fever, and acute kidney injury following intense physical exertion amidst a severe heat wave. Although initially managed as heat stroke, the patient soon exhibited dysarthria, palatal weakness, and bilateral lower limb weakness with areflexia, prompting a detailed neurological assessment. Electromyography and nerve conduction studies revealed the acute motor-sensory axonal neuropathy (AMSAN) variant of Guillain-Barré Syndrome (GBS), an uncommon but severe sequel of heat stroke. GBS, an autoimmune disorder, typically presents with ascending bilateral lower limb flaccid paralysis, often following an acute infectious trigger. Treatment with plasmapheresis led to remarkable neurological recovery. This case represents the first documented instance of heat stroke-induced GBS in Pakistan, highlighting both the distinctive clinical features and the therapeutic complexities of this rare condition.

Thermodynamic Properties of Two Cinnamate Derivatives with Flavor and Fragrance Features

The standard molar enthalpies of formation in the liquid phase for ethyl (E)-cinnamate and ethyl hydrocinnamate, two cinnamate derivatives with notable flavor and fragrance characteristics, were determined experimentally using combustion calorimetry in an oxygen atmosphere. To derive the gas-phase enthalpies of formation for these derivatives, their enthalpies of vaporization were measured using a high-temperature Calvet microcalorimeter and the vacuum drop microcalorimetric technique. Additionally, a computational analysis employing the G3(MP2)//B3LYP composite method was conducted to calculate the gas-phase standard enthalpies of formation at T = 298.15 K for both compounds. These findings enabled a detailed assessment and analysis of the structural and energetic effects of the vinyl and ethane moieties between the phenyl and carboxylic groups in the studied compounds. Considering the structural features of ethyl (E)-cinnamate and ethyl hydrocinnamate, a gas-phase enthalpy of hydrogenation analysis was conducted to explore their energetic profiles more thoroughly.

Current approaches to prenatal imaging of lung malformations: a review

INTRODUCTION: Congenital lung malformations are result of developmental disorders at any stage of organ formation. Manifestations of these changes vary significantly: from minimal in size to large space-occupying lesion of the lung, which can cause fetal death or severe postnatal respiratory disorders. In proper time and accurate prenatal diagnosis of lung development abnormalities is one of the fundamental factors determining management of pregnancy and prognosis.OBJECTIVE: To demonstrate the most typical features of a wide range of congenital lung anomalies by ultrasound and MRI.MATERIALS AND METHODS: The literature search was performed in open Russian and English databases Medline, PubMed, Web of Science, RSCI, eLIBRARY using keywords and phrases: «prenatal diagnosis», «fetal MRI», «ultrasound diagnostics», «сongenital lung malformations».RESULTS: Based on literature data and our own experience in the use of ultrasound and MRI in diagnosis of сongenital lung malformations, the main signs of normal development and the most specific types of lung anomalies are described. Algorithm for diagnostic search for congenital lung malformations is presented.CONCLUSION: Ultrasound is the main method for diagnosing congenital lung anomalies. Fetal MRI is used to clarify the nature and extent of changes, a more detailed assessment of adjacent organs, also to determine Multiple congenital anomalies. Understanding the characteristics of semiotics of lung malformations and the main signs of these anomalies is a fundamental criterion for prenatal counseling, as well as peri- and postnatal management of this category of patients.

Mapping and characterization of the liquefaction impacts of the July and October 2022 earthquakes in Northwestern Luzon, Philippines

The 25 July 2022 MW 7.0 and 25 October 2022 MW 6.4 earthquakes caused liquefaction in the lowlands of Northwestern Luzon, Philippines. With the widespread liquefaction occurrence, a methodology was developed for mapping and assessing its impacts, which combined mapping techniques, geomorphological analysis, review of historical liquefaction accounts and empirical equations, utilization of available remote sensing technologies, and application of various geophysical and geotechnical equipment. The majority of liquefaction impacts of the MW 7.0 earthquake occurred along the Abra River delta, while the MW 6.4 earthquake had most of its liquefaction impacts concentrated in river dikes and abandoned channels across the Solsona Basin. Grain size analysis confirmed that the sediments indeed had the potential to liquefy. The soil parameters obtained using the refraction microtremor (ReMi) and screw driving sounding (SDS) tests also showed strong correlations, with liquefaction potential values ranging from low to high. Soil period values were also consistent with the ReMi and SDS results.The results of this study emphasize that: 1) detailed mapping and assessment of areas affected by liquefaction is valuable in aiding researchers and planners in hazard mitigation; and 2) the geophysical and geotechnical approaches employed are suitable and less invasive alternatives in site-specific liquefaction potential assessment.

Impact of Clinical and Pharmacological Parameters on Faecal Microbiota Transplantation Outcome in Clostridioides difficile Infections: Results of a 5-Year French National Survey.

Detailed comparative assessment of procedure-related factors associated with faecal microbiota transplantation (FMT) efficacy in Clostridioides difficile infection (CDI) is limited. We took advantage of the differences in procedures at the various French FMT centres to determine clinical and procedure-related factors associated with FMT success in CDI. We performed a nationwide retrospective multicentre cohort study. All FMTs performed within The French Faecal Transplant Group for CDI from 2018 to 2022 were included. Clinical data were collected retrospectively from recipient medical files, characteristics of stool transplant preparations were prospectively collected by each Pharmacy involved. Univariate and multivariate analyses were performed using Fisher's test and multiple logistic regression. Six hundred fifty-eight FMTs were performed for 617 patients in 17 centres. The overall efficacy of FMT was 84.3% (520/617), with 0.5% of severe adverse events possibly related to FMT (3/658). Forty-seven patients were treated at the first recurrence of CDI with a similar success rate (85.1%). Severe chronic kidney disease (CKD; OR: 2.18, 95%CI [1.20-3.88]), non-severe refractory CDI (OR: 15.35, [1.94-318.2]), the use of ≥ 80% glycerol (OR: 2.52, [1.11-5.67]), insufficient bowel cleansing (OR: 5.47, [1.57-20.03]) and partial FMT retention (OR: 9.97, [2.62-48.49]) were associated with CDI recurrence within 8 weeks. Conditions of transplant manufacturing, bowel cleansing, and a route of delivery tailored to the patient's characteristics are key factors in optimising FMT efficacy. FMT at first recurrence showed high success in real-life practice, whereas it had lower efficacy in severe CDI and non-severe refractory CDI.

Humoral and T-cell-mediated responses to an insect-specific flavivirus-based Zika virus vaccine candidate.

Flaviviruses represent a significant global health threat and relatively few licensed vaccines exist to protect against them. Insect-specific flaviviruses (ISFVs) are incapable of replication in humans and have emerged as a novel and promising tool for flavivirus vaccine development. ISFV-based flavivirus vaccines have shown exceptional safety, immunogenicity, and efficacy, however, a detailed assessment of the correlates of protection and immune responses induced by these vaccines are still needed for vaccine optimization. Here, we explore the mechanisms of protective immunity induced by a previously created pre-clinical Zika virus (ZIKV) vaccine candidate, called Aripo/Zika (ARPV/ZIKV). In brief, immunocompromised IFN-αβR-/- mice passively immunized with ARPV/ZIKV immune sera experienced protection after lethal ZIKV challenge, although this protection was incomplete. ARPV/ZIKV-vaccinated IFN-αβR-/- mice depleted of CD4+ or CD8+ T-cells at the time of ZIKV challenge showed no morbidity or mortality. However, the adoptive transfer of ARPV/ZIKV-primed T-cells into recipient IFN-αβR-/- mice resulted in a two-day median increase in survival time compared to controls. Altogether, these results suggest that ARPV/ZIKV-induced protection is primarily mediated by neutralizing antibodies at the time of challenge and that T-cells may play a comparatively minor but cumulative role in the protection observed. Lastly, ARPV/ZIKV-vaccinated Tcra KO mice, which are deficient in T-cell responses, experienced significant mortality post-challenge. These results suggest that ARPV/ZIKV-induced cell-mediated responses are critical for development of protective immune responses at vaccination. Despite the strong focus on neutralizing antibody responses to novel flavivirus vaccine candidates, these results suggest that cell-mediated responses induced by ISFV-based vaccines remain important to overall protective responses.

Examining problem gambling, substance use disorders and cluster B personality traits among incarcerated individuals

Prison populations face heightened rates of addictive behaviors and significant stressors, including health challenges and social disparities. Although problem gambling is prevalent in criminal justice settings, its distinctiveness compared to other addictions among incarcerated individuals remains uncertain. This study examines risk factors associated with problem gambling in Finnish prisoners and explores differences compared to other forms of addiction.Covariates from a questionnaire (N = 527) included gender, age, education, offender status, involvement in theft or property crime, Trauma Screening Questionnaire (TSQ), Depression Scale (DEPS), and lifetime abuse experiences. Of the 527 participants, 330 were interviewed using the Structured Clinical Interview (SCID-II) to assess personality disorders. Multiple logistic regression models were utilized, with separate models for problem gambling (PG), lifetime substance use disorder, and lifetime alcohol disorder.Crime type was not significantly associated with alcohol or substance use problems, but PG was associated with property crime or theft convictions. Borderline personality traits were linked to probable PG, while antisocial traits were linked to drug use, and both traits predicted alcohol misuse. Age and gender were significant only in relation to alcohol use problems, with older age and male gender indicating higher risk.The association between problem gambling and criminal behavior underscores the vulnerability of incarcerated individuals across various domains. Detailed assessments, considering the nature of criminal activity and personality disorders, especially borderline traits and comorbid conditions, are crucial for tailoring rehabilitation and treatment strategies to prevent recidivism. These findings provide valuable insights for clinicians managing addiction and mental health issues within correctional settings.

Assessment of vitamin B12 and folate status and their determinants in children aged 6–59 months with severe acute malnutrition admitted to a tertiary-care centre in North India

ABSTRACT Background Vitamin B12 and folate are essential micronutrients, a deficiency of which causes anaemia, poor growth and an increased risk of infections, along with irreversible neurological damage to the developing brain in children. Methods A hospital-based prospective observational study was conducted in 100 children with severe acute malnutrition (SAM) aged 6–59 months admitted to a tertiary-care facility in northern India from July 2021 to June 2022. A structured proforma was used to record socio-demographic information, a detailed clinical history, results of general and systemic physical examination and a detailed anthropometric assessment. Serum folate and vitamin B12 were estimated by electrochemiluminescence. Results The mean age of the children was 24.18 months, and 64.0% were aged 6–12 months. The male-to-female ratio was 1.08:1. Anaemia was present in 87.0% of the children, and it was severe in 35% of them. There was serum vitamin B12 and folate deficiency in 61.0% and 19.0%, respectively. A deficiency of vitamin B12 was significantly associated with delayed developmental milestones in all domains, a mid-upper-arm circumference of <11.5 cm, severe anaemia, a low platelet count and folate deficiency, and a folate deficiency was significantly associated with older age, delayed developmental milestones in all domains, severe anaemia, a low platelet count and vitamin B12 deficiency. Conclusion Vitamin B12 deficiency is highly prevalent in children aged 6–59 months with SAM, but the prevalence of folate deficiency is much lower. Apart from iron and folic acid supplementation, government programmes should consider vitamin B12 supplementation for children aged 6–59 months.

A Rare Clinical Case of Migrating Pericardial Cyst Mimicking Encysted Pleural Effusion

Pericardial cysts are rare benign tumors often discovered incidentally during radiological examinations. Despite being predominantly asymptomatic, they can cause significant clinical manifestations and complications. The article describes a case of migrating pericardial cyst that was initially misinterpreted as left-sided encysted pleural effusion. Detailed assessment of dynamic changes on multislice computed tomography and subsequent surgical treatment revealed that the neoplasm originated from the pericardial layers altering its location, shape, and size. Awareness of the phenomenon of pericardial cyst migration and the use of up-to-date imaging techniques play a crucial role in accurate diagnosis and selecting optimal treatment strategies.

Reproductive and developmental toxicity of α-terpineol in Wistar rats

Alpha-terpineol (α-T) is a type of monoterpenoid alcohol commonly present in essential oils, it contributes to a pleasant floral fragrance similar to that of lilacs. This research aimed to evaluate the impact of α-terpineol on the reproductive functions of both male and female rats, including gonadal activity, mating behavior, conception, conceptus development and parturition. Six male and female Wistar rats per group received α-terpineol through gavage at doses of 0, 75, 150 and 300 mg/kg/day. The study revealed changes in body weight gain inhibition, food consumption, azoospermia, decreased testosterone levels (0.7 ± 1.61 ng/mL, 0.7 ± 2.30 ng/mL) as well as histopathological variations in testis and epididymis among males exposed to doses of 150 and 300 mg/kg/day. Moreover, this exposure led to significantly decreased serum T4 levels in both adult males (21.85 ± 12.68 ng/mL, 16.20 ± 9.15 ng/mL) and dams (11.24 ± 12.37 ng/mL, 9.48 ± 11.74 ng/mL) at the dose range of 150 and 300 mg/kg/day without affecting TSH concentrations. In summary, the present study showed that α-terpineol induced reproductive toxicities in male rats. Therefore, a detailed toxicological assessment is highly recommended.

Environmental Impact of Polyurethane-Based Aerogel Production: Influence of Solvents and Solids Content

This study provides a comprehensive analysis of the environmental impacts associated with the synthesis of polyurethane (PUR) aerogels. The synthesis process incorporates various solvents and solids contents into the formulation, with the primary objective of enhancing the physical properties of the aerogels for broad industrial applications. Nine experimental scenarios were explored, grouped into two sets based on the variables studied. A detailed Life Cycle Assessment (LCA) was conducted to evaluate the environmental impacts of all formulated PUR aerogels. The findings indicate that a solvent solution of 100% ethyl acetate (EtOAc) results in lower environmental impacts compared to other tested formulations. Notably, a solvent solution comprising 75% acetonitrile (ACN) and 25% EtOAc exhibited the highest environmental Key Performance Indicator (εKPI) among the tested material formulations, closely followed by the PUR aerogel obtained using acetone as a solvent. Furthermore, this study underscores the necessity of performing an integrated LCA that considers both environmental and functional aspects. While reducing the solids content is environmentally advantageous, it may present challenges in terms of material functionality. This is illustrated by the PUR aerogel synthesized with the lowest solids content of 3.2 wt.%, which demonstrated high deformability, thereby complicating the determination of a reliable Young’s modulus for analysis.

Coupled thermal-electrical–mechanical characteristics of lightning damage in woven composite honeycomb sandwich structures

In this study, lightning strike damage of woven carbon fibre-reinforced polymer laminates (W-CFRPs) and woven composite honeycomb sandwich panels (W-CHSPs) are simulated using the proposed sequential thermal-electrical–mechanical finite element (FE) coupling model incorporating dielectric breakdown of materials. Surface current with an amplitude of 200 kA and corresponding lightning shockwave overpressure were applied on each composite. The FE model coupled with LaRC05 criterion was used to study the failure behaviours of intralaminar damage and interlaminar delamination of the W-CFRPs and W-CHSPs. A series of lightning strike tests were performed to validate the FE model. Detailed lightning damage assessments and mechanisms were characterized by a combination of visual inspection, image processing, ultrasonic scanning and micro computed tomography (Micro-CT) and showed good agreements with the FE-predicted results. It can be concluded that shockwave overpressure significantly impacts lightning-induced damages, thereby supporting the effectiveness of the newly proposed sequential thermal-electrical–mechanical coupling model, which demonstrates improved predictive accuracy.

7086 Disrupted Mitochondrial Function in Alström Syndrome- A Monogenic Model of Insulin Resistance and Obesity

Abstract Disclosure: S. Ali: None. S. Heising: None. V. Veeranna: None. A. Vincent: None. G.S. Xavier: None. T. Geberhiwot: None. Alström syndrome (ALMS) is a rare monogenic disease typified by severe insulin resistance (IR) and obesity. IR and obesity are cardinal features of metabolic syndrome. The metabolic effects of insulin at key target tissues leads to metabolic haemostasis by promoting glucose and lipid uptake and metabolism to generate energy in cells. Although insulin is a major regulator of fuel metabolism, its effects on mitochondrial ATP production in severe insulin resistance are unclear. RNASeq data from adipose tissue (AT) from patients with ALMS show downregulation of the expression of genes associated with mitochondrial respiratory chain function, pointing towards possible altered mitochondrial function in ALMS. We therefore undertook a detailed assessment of mitochondrial oxidative phosphorylation capacity (OXPHOS) in skeletal muscle (SM) in ALMS. We performed SM biopsy in 10 ALMS and 10 healthy control volunteers that were age, gender and Body Mass Index matched. The SM was subjected to high resolution respirometry, the gold standard method to quantify mitochondrial function ex vivo, using OROBOROS Oxygraph -2k (O2k) system. Overall OXPHOS was higher in control SM compared to ALMS, with maximal respiration of 62.96±19.2 and 44.24 ± 12.53 pmol/(s*mg), respectively (p&amp;lt;0.05).Reduced oxygen influx was observed in ALMS SM in comparison to controls for fatty acid ß oxidation (6.7±5.96 vs 7.87±2.7 pmol/(s*mg);p&amp;lt;0.05, at complex I (19.4 ± 8.98 vs 29.7 ±5.3 pmol/(s*mg);p&amp;lt;0.05, and at complex II (34.98 ±11.75 vs 53.52± 13.2 pmol/(s*mg) ;p&amp;lt;0.05. Mitochondrial membrane integrity was unaffected during these experiments. Therefore, our analysis unveils a consistent reduction in mitochondrial respiration across all the electron transport pathway. This noteworthy finding suggests impairment in respiratory function and the electron transport chain in mitochondria, a crucial aspect of cellular energy metabolism. Several studies have previously linked IR with mitochondrial dysfunction, where insulin-resistant rodents and humans have shown blunted mitochondrial response to ATP generation. Our results align with this body of evidence emphasizing the significance of investigating the underlying mechanism contributing to this phenomenon. These findings could pave the way to exploring potential mitochondrial-targeted therapies to restore mitochondrial function and therefore, improve insulin sensitivity to tackle IR in ALMS. Presentation: 6/2/2024

Investigating Mood and Cognition in People with Multiple Sclerosis: A Prospective Study Protocol.

Strengths and Limitations of this Study: We will use MS as a model to study how white matter disease contributes to both the pathophysiology of depression in MS and to general network mechanisms of depression.We will leverage research-grade 3-tesla (3T) MRIs acquired as part of routine MS care and maximize scalability by using the Method for Inter-Modal Segmentation Analysis (MIMoSA) for automated white matter lesion segmentation.Our study will include participants with medical comorbidities, creating a more representative population and more broadly applicable results.We will obtain detailed clinical and cognitive assessments from each participant to evaluate the inter-relationship of mood symptoms, anxiety symptoms, and cognitive deficits, and relate them to white matter disease.This is a single-center study.

Prediction and evaluation of the low-frequency noise impact from industrial noise sources

German legislation requires an assessment of low-frequency noise in addition to the regular noise assessment for industrial plants. The detailed prediction and assessment of low-frequency noise immissions is carried out according to the administrative regulation for noise TA Lärm and the German standard DIN 45680. However, a standardised procedure for predictions of low-frequency noise does not exist. For this reason, different approaches for the prediction of low-frequency noise immissions have been developed over the last two decades. Typically, the method according to DIN ISO 9613-2 for sound propagation outside is extended heuristically to the lower frequency range. The predicted low-frequency noise level outside the room is taken as a basis for determining the noise immission level inside the room. The level of knowledge about the quality of sound propagation modeling of low-frequency noise is still debatable. A forecast method of low-frequency noise components should be on the "safe side" in terms of noise control; however, the scope of the required measures to meet the noise requirements must be comprehensible and proportionate. We present an overview of the building blocks of a forecasting process and the challenges that arise. The topic is illustrated by a practical example.

If EQ-5D-5L Mobility Dimension Ratings Are High, Is Life-Space Assessment a Clinically Sensible Next Step? Data from a Population Survey.

Background: Impaired health states can limit a person's mobility, often progressively for people with life-limiting illnesses. Quantifying mobility changes is crucial for individual clinical care and service planning. Objective: To explore any correlation between EQ-5D-5L's mobility dimension ratings and Life-Space Assessment (LSA) from a population sample. Methods: An online population survey of Australian adults, nationally-representative by key demographics. An analysis of variance examined each level of the EQ-5D-5L mobility dimension rating against its LSA scores; Kendall's Tau assessed correlation. Results: Participants (n = 6366) were 53% women, mean age 46.1 years (SD 18.6), and mean LSA score 78.0 (SD = 27.5; possible range 0-120). At each EQ-5D-5L mobility dimension level there was a significant difference between LSA scores (p < 0.001), and a moderate negative correlation (Kendall's tau b = -0.342) between the two measures. Conclusion: Given the relationship defined, EQ-5D-5L mobility dimension ratings may prompt clinicians to consider further evaluation with the more detailed Life-Space Assessment. .