Factor analysis, causal indicators and quality of life

Exploratory factor analysis (EFA) remains one of the standard and most widely used methods for demonstrating construct validity of new instruments. However, the model for EFA makes assumptions which may not be applicable to all quality of life (QOL) instruments, and as a consequence the results from EFA may be misleading. In particular, EFA assumes that the underlying construct of QOL (and any postulated subscales or factors) may be regarded as being reflected by the items in those factors or subscales. QOL instruments, however, frequently contain items such as diseases, symptoms or treatment side effects, which are causal indicators. These items may cause reduction in QOL for those patients experiencing them, but the reverse relationship need not apply: not all patients with a poor QOL need be experiencing the same set of symptoms. Thus a high level of a symptom item may imply that a patient's QOL is likely to be poor, but a poor level of QOL need not imply that the patient probably suffers from that symptom. This is the reverse of the common EFA model, in which it is implicitly assumed that changes in QOL and any subscales cause or are likely to be reflected by corresponding changes in all their constituent items; thus the items in EFA are called effect indicators. Furthermore, disease-related clusters of symptoms, or treatment-induced side-effects, may result in different studies finding different sets of items being highly correlated; for example, a study involving lung cancer patients receiving surgery and chemotherapy might find one set of highly correlated symptoms, whilst prostate cancer patients receiving hormone therapy would have a very different symptom correlation structure. Since EFA is based upon analyzing the correlation matrix and assuming all items to be effect indicators, it will extract factors representing consequences of the disease or treatment. These factors are likely to vary between different patient subgroups, according to the mode of treatment or the disease type and stage. Such factors contain little information about the relationship between the items and any underlying QOL constructs. Factor analysis is largely irrelevant as a method of scale validation for those QOL instruments that contain causal indicators, and should only be used with items which are effect indicators.     

Some observations on the mechanism of pressure related atrial fibrillation

In order to investigate the effect of atrial pressure on thepropensity of the atria to fibrillate and the mechanism of thisassociation, the right atrial pressure was changed acutely bytransfusion-bleeding in 12 anaesthetized open-chest dogs. Undervarious atrial pressures the conduction time was measured betweentwo pairs of hook electrodes positioned on the two atrial appendagesrespectively. The effective refractory period was measured bycontinuous pacing of the right atrium at a 250 ms cycle lengthat double threshold intensity and interpolating a progressivelyearlier stimulus after each eighth paced beat. The propensityof fibrillation was studied by rapid (450 min^–1) pacingof the atria at double threshold intensity for 10 s at differentatrial pressures. At a high (14 mmHg) atrial pressure the conductiontime (45.7 ± 14.2 ms) was significantly (P<0.01) longer,the effective refractory period (157.9 ± 15.2 ms) significantly(P<0.01) longer and the atrial fibrillation (11/19 or 57.9%)significantly (X² = 9.95, P<0.001) more common than at alow ( 10 mmHg) pressure (35.2 ± 11.6, 146.2 ±12.4, 3/24 or 12.5%, respectively). Analysis of variance showedthat the probability of atrial fibrillation was significantlyaffected by the atrial pressure but not by either the conductiontime or the effective refractory period The findings suggestthat an increase in right atrial pressure by acute volume overloadprolongs the inter-atrial conduction time and right atrial refractorinessand increases the propensity of the atria tofibrillate by rapidatrial stimulation. The effect of atrial pressure on fibrillationdoes not seem to be mediated by the prolonged atrial refractorinessor conduction time.     

Solubility Enhancement of Nucleosides and Structurally Related Compounds by Complex Formation

Water-soluble vitamins, amino acids, and nontoxic pharmaceutical excipients were studied as solubilizing agents for poorly water-soluble adenine (nucleic acid base), guanosine (nucleoside), and structurally related drugs (acyclovir and triamterene). The apparent solubility of the substrates (adenine, guanosine, acyclovir, or triamterene) was appreciably increased by forming complexes with the ligands (vitamins, amino acids, or other ligand). Apparent association constants (K _a ) values were measured at 25°C in pH 7 phosphate buffer using phase solubility analysis. The effect of combination ligands on substrate solubility was also studied. Additive solubility enhancement was obtained for several ligand pairs.     

Callosal connections of the parabelt auditory cortex in macaque monkeys

Auditory cortex of macaque monkeys is located on the lower bank of the lateral sulcus and the adjoining superior temporal gyrus. This region of cortex contains a core of primary-like areas surrounded by a narrow belt of associated fields. Adjacent to the lateral belt on the superior temporal gyrus is a parabelt region which contains at least two subdivisions (rostral and caudal). In previous studies we defined the parabelt region as cortex with topographic cortical connections with the belt areas surrounding the core, and connections with the dorsal and magnocellular divisions of the medial geniculate complex, but minimal connections with the core region and ventral division of the medial geniculate complex. The callosal connections of the parabelt auditory cortex were determined by placing injections, of up to six distinguishable tracers, into different locations of the parabelt region in each of four macaque monkeys. The results indicated that the strongest callosal projections arise from homotopic areas in parabelt cortex, and they roughly matched the rostrocaudal levels of the medial and lateral belt cortex. Weaker callosal inputs to the parabelt originate from the corresponding levels of the superior temporal gyrus and superior temporal sulcus. The core region does not contribute significant callosal projections to the parabelt region. The results provide further support for the conclusion that the parabelt region represents a third level of auditory cortical processing beyond direct activation by primary subcortical and cortical auditory structures.     

装修后室内甲醛、苯系物浓度影响因素研究

目的　了解装修后室内甲醛、苯系物污染状况与装修时间、板材使用量、通风等因素之间的关系 ,为装修后科学选择入住时间提供依据。方法　选择装修后 3～ 18周居室进行调查 ,分析调查因素与污染物浓度的关系。结果　室内甲醛浓度与人造板材使用量、通风时间、检测时的温度等因素有明显的相关关系 (P<0 .0 5 ) ,苯系物浓度与装修时间、通风时间等因素有明显的相关关系 (P <0 .0 5 ) ;甲醛、苯系物浓度与楼层、房屋高度等因素无明显的相关关系 (P >0 .0 5 )。结论　室内装修不宜过多使用人造板材。装修后应该保持经常通风。入住时间一般应在装修结束 13周以后。     

改进的亚硫酸氢钠测序法检测HepG2 RASSF1A基因CpG岛甲基化状态

目的 改进亚硫酸氢钠测序法，并检验改进后方法在甲基化检测中的可行性。方法 提取人肝癌细胞株HepG2基因组DNA，亚硫酸氢钠化学修饰，针对修饰后Ras相关家族1A基因（RASSF1A）启动子序列设计特异引物并结合沉降PCR扩增，T-A载体克隆、测序。结果 HepG2细胞RASSF1A基因启动子CpG岛的16个CpG位点均被甲基化。结论 改进后亚硫酸氢钠测序法能明显减少非特异性扩增，提高PCR效率，更适于基因甲基化状态的检测。