The Consulting Consortium

London, United Kingdom

The Consulting Consortium

London, United Kingdom

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PubMed | Childrens Hospital Colorado, The Consulting Consortium, Pediatric Intensive Care Unit and Section of Nutrition Childrens Hospital Colorado
Type: Journal Article | Journal: The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG | Year: 2014

To compare 3 methods of weight determination for medication dose calculations in obese children and to discuss feasibility for use in routine care.This was a patient safety and quality improvement study evaluating patients (2-19 years old) admitted to the pediatric intensive care unit during a 13-month period (July 2010-July 2011). Patients identified as obese (95th percentile body mass index [BMI] for age), including severely obese (99th percentile BMI for age), were included in the weight method comparison portion of this study. Lean body mass estimations, using equations derived by the Peters and Foster methods, were compared to ideal body weight estimates by using the BMI method. Absolute differences between values generated by the 3 methods, intraclass correlation (ICC), and Bland-Altman plots were calculated.A total of 1369 patients met initial criteria; 176 met criteria for the dosing weight comparison (age SD = 9.28 5 years; actual weight SD = 55.5 33.9 kg; 46% female). Sixty were severely obese and 116 were obese. Mean ICC between methods was 0.968 (95% Confidence interval (CI): 0.959, 0.975). The Peters method estimated higher weights than the Foster or BMI method. Bland-Altman plots illustrated good agreement between methods in children with weight below 50 kg, but decreased agreement above 50 kg, which was influenced by sex.All methods demonstrated strong correlation and acceptable agreement in children below 50 kg. Systematic biases were identified in children above 50 kg where variance was higher. The BMI method was least complex to calculate and the most feasible method for daily use.


Mariotto I.,New Mexico State University | Gutschick V.P.,The Consulting Consortium
Remote Sensing | Year: 2010

The application of energy balance algorithms to remotely sensed imagery often fails to account for surface roughness variation with diverse land cover, resulting in poor resolution of evapotranspiration (ET) variations. Furthermore, the assumption of a horizontally homogeneous Lambertian surface reflecting energy equally in all directions affects the calculations of albedo and vegetation index. The primary objective of this study is to improve the accuracy of the estimation and discrimination of ET among different land cover types in Southern New Mexico from ASTER datasets, by formulating the spatial variation of non-Lambertian reflectance using a wavelength-dependent Minnaert function. © 2010 by the authors; licensee Molecular Diversity Preservation International, Basel, Switzerland.


Mariotto I.,New Mexico State University | Gutschick V.P.,The Consulting Consortium | Clason D.L.,New Mexico State University
Photogrammetric Engineering and Remote Sensing | Year: 2011

Accurate estimation of evapotranspiration (ET) is difficult to obtain over heterogeneous landscapes presenting spectrally diverse land covers and topographic terrains. The goal of this study is to build advanced remote sensing and surface energy balance algorithms to map ET in a heterogeneous semi-arid area. ET of 12 different land covers is computed by applying the Surface Energy Balance Algorithm for Land (SEBAL) modified for roughness, vegetation index, and topographiccorrected reflectance, with comparison to the JIC model. A GIS raster/vector platform is used to integrate multispectral thermal and reflectance imagery with meteorological, terrain, land-cover, and astronomical data. SEBAL computed with all the modifications showed the best agreement with the ground measurements, compared to the SEBAL versions without any single modification, and it could significantly discriminate ET among 75.8 percent of vegetation types (at threshold differences in ET >0.5 mm/day). SEBAL without any modifications could not discriminate any vegetation types. © 2011 American Society for Photogrammetry and Remote Sensing.


Gutschick V.P.,The Consulting Consortium | Sheng Z.,Texas AgriLife Research Center
Agricultural Water Management | Year: 2013

We constructed and validated against eddy-covariance data a model of the fluxes of water vapor, sensible heat, CO2, and radiation in a substantially mature pecan orchard (Carya illinoinensis (Wangenh.)K. Koch) in an arid environment near El Paso, TX, USA. The detailed process-based model is designed for insights into major control points for photosynthetic gain and water use as exerted by canopy structure, leaf physiology, and micrometeorological drivers. Toward this end, it resolves extensive details of leaf micro environments (radiation and scalars) in realistic canopy structures, as well as photosynthetic and respiratory physiology, stomatal control, and water relations from roots to leaves. The model is for a static mid-season canopy, with the ability to link it to dynamics models of development and management. Field flux measurements agreed well with model estimates that were derived using measurable parameters rather than data-fitting. An exception was the measurement-model disparity in sensible heat flux under conditions of strong advection of dry air; the model diagnostics imply a marked insensitivity of pecan stomata to humidity that has not been reported earlier. Formulation and parametrization of most of the physical and physiological processes was robust, shared well between the study site and an alternate site, but gaps are evident in the knowledge of several important processes, primarily in responses to water stress. The study indicates limitations in simpler models, such as those based on constant canopy conductance or light-use efficiency, while offering leads to making more accurate simple models suitable for use in decision support systems, ultimately for stress management under limited water availability. © 2013 Elsevier B.V.


Thomas E.A.,Aurora University | Bechtell J.L.,Aurora University | Vestal B.E.,The Consulting Consortium | Johnson S.L.,Aurora University | And 4 more authors.
Appetite | Year: 2013

While the majority of Americans are now overweight, some individuals maintain their weight with minimal effort. This study investigated behavioral differences between 58 individuals recruited as either obese-resistant (OR) or obese-prone (OP) based on self-identification, BMI, and personal/family weight history. Subjects were studied during Eucaloric (EU), Overfed (OF), and Underfed (UF) phases which included a run-in diet, 1. day intervention diet, and a study day. At baseline, subjects completed the Three Factor Eating Questionnaire (TFEQ) and Power of Food Scale (PFS). On the study day, ratings of appetite, food appeal and desire, and food cravings were performed in response to a breakfast shake. OF resulted in reduced hunger and food desire while UF resulted in increased hunger and food appeal and desire. While hunger did not differ between groups, OP had higher scores for TFEQ measures (hunger, restraint and disinhibition), higher "hedonic hunger" as measured by the PFS, and greater food cravings and ratings of food appeal and desire. These results suggest that subjective hunger and desire for food change significantly after only one day of over- or underfeeding. Additionally, we found several behavioral differences between groups that are likely to promote weight gain over time in the OP. © 2013 Elsevier Ltd.


Steele A.K.,Aurora University | Lee E.J.,Aurora University | Vestal B.,The Consulting Consortium | Hecht D.,Aurora University | And 5 more authors.
PLoS ONE | Year: 2014

Background: Systemic inflammation is a characteristic of both HIV-1 infection and aging ("inflammaging"). Intestinal epithelial barrier damage (IEBD) and microbial translocation (MT) contribute to HIV-associated inflammation, but their impact on inflammaging remains unclear. Methods: Plasma biomarkers for IEBD (iFABP), MT (LPS, sCD14), T-cell activation (sCD27), and inflammation (hsCRP, IL-6) were measured in 88 HIV-1 uninfected (HIV neg) and 83 treated, HIV-1-infected (HIVpos) adults from 20-100 years old. Results: Age positively correlated with iFABP (r = 0.284, p = 0.008), sCD14 (r = 0.646, p = <0.0001) and LPS (r = 0.421, p = 0.0002) levels in HIVneg but not HIVpos subjects. Age also correlated with sCD27, hsCRP, and IL-6 levels regardless of HIV status. Middle-aged HIVpos subjects had elevated plasma biomarker levels similar to or greater than those of elderly HIVneg subjects with the exception of sCD14. Clustering analysis described an inflammaging phenotype (IP) based on iFABP, sCD14, sCD27, and hsCRP levels in HIVneg subjects over 60 years of age. The IP in HIVneg subjects was used to develop a classification model that was applied to HIVpos subjects to determine whether HIVpos subjects under 60 years of age were IP+. HIV pos IP+ subjects were similar in age to IP- subjects but had a greater risk of cardiovascular disease (CVD) based on Framingham risk score (p = 0.01). Conclusions: We describe a novel IP that incorporates biomarkers of IEBD, MT, immune activation as well as inflammation. Application of this novel IP in HIV-infected subjects identified a group at higher risk of CVD. © 2014 Steele et al.


Penman M.,The Consulting Consortium | Banton M.,One Houston Center | Erler S.,SABIC | Moore N.,Ubrs Consulting GmbH | Semmler K.,Royal Dutch Shell
Chemico-Biological Interactions | Year: 2015

REACH (Registration, Evaluation, Authorisation and Restriction of Chemicals) is the European Union's chemical regulation for the management of risk to human health and the environment (European Chemicals Agency, 2006). This regulation entered into force in June 2007 and required manufacturers and importers to register substances produced in annual quantities of 1000 tonnes or more by December 2010, with further deadlines for lower tonnages in 2013 and 2018. Depending on the type of registration, required information included the substance's identification, the hazards of the substance, the potential exposure arising from the manufacture or import, the identified uses of the substance, and the operational conditions and risk management measures applied or recommended to downstream users. Among the content developed to support this information were Derived No-Effect Levels or Derived Minimal Effect Levels (DNELs/DMELs) for human health hazard assessment, Predicted No Effect Concentrations (PNECs) for environmental hazard assessment, and exposure scenarios for exposure and risk assessment. Once registered, substances may undergo evaluation by the European Chemicals Agency (ECHA) or Member State authorities and be subject to requests for additional information or testing as well as additional risk reduction measures. To manage the REACH registration and related activities for the European olefins and aromatics industry, the Lower Olefins and Aromatics REACH Consortium was formed in 2008 with administrative and technical support provided by Penman Consulting. A total of 135 substances are managed by this group including 26 individual chemical registrations (e.g. benzene, 1,3-butadiene) and 13 categories consisting of 5-26 substances. This presentation will describe the content of selected registrations prepared for 2010 in addition to the significant post-2010 activities. Beyond REACH, content of the registrations may also be relevant to other European activities, for example consideration of worker DNELs/DMELs for occupational exposure level setting, discussion of this aspect will be presented for 1,3-butadiene. © 2015 Elsevier Ireland Ltd.


PubMed | University of Sydney, The Consulting Consortium, University of Melbourne and University of Western Sydney
Type: Journal Article | Journal: Health policy (Amsterdam, Netherlands) | Year: 2015

In undertaking a major revision to the Australian Refined Diagnosis Related Group (ARDRG) classification, we set out to contrast Australias approach to using data on additional (not principal) diagnoses with major international approaches in splitting base or Adjacent Diagnosis Related Groups (ADRGs).Comparative policy analysis/narrative review of peer-reviewed and grey literature on international approaches to use of additional (secondary) diagnoses in the development of Australian and international DRG systems.European and US approaches to characterise complexity of inpatient care are well-documented, providing useful points of comparison with Australias. Australia, with good data sources, has continued to refine its national DRG classification using increasingly sophisticated approaches. Hospital funders in Australia and in other systems are often under pressure from provider groups to expand classifications to reflect clinical complexity. DRG development in most healthcare systems reviewed here reflects four critical factors: these socio-political factors, the quality and depth of the coded data available to characterise the mix of cases in a healthcare system, the size of the underlying population, and the intended scope and use of the classification. Australias relatively small national population has constrained the size of its DRG classifications, and development has been concentrated on inpatient care in public hospitals.Development of casemix classifications in health care is driven by both technical and socio-political factors. Use of additional diagnoses to adjust for patient complexity and cost needs to respond to these in each casemix application.


PubMed | Royal Dutch Shell, The Consulting Consortium, SABIC, Ubrs Consulting GmbH and One Houston Center
Type: | Journal: Chemico-biological interactions | Year: 2015

REACH (Registration, Evaluation, Authorisation and Restriction of Chemicals) is the European Unions chemical regulation for the management of risk to human health and the environment (European Chemicals Agency, 2006). This regulation entered into force in June 2007 and required manufacturers and importers to register substances produced in annual quantities of 1000 tonnes or more by December 2010, with further deadlines for lower tonnages in 2013 and 2018. Depending on the type of registration, required information included the substances identification, the hazards of the substance, the potential exposure arising from the manufacture or import, the identified uses of the substance, and the operational conditions and risk management measures applied or recommended to downstream users. Among the content developed to support this information were Derived No-Effect Levels or Derived Minimal Effect Levels (DNELs/DMELs) for human health hazard assessment, Predicted No Effect Concentrations (PNECs) for environmental hazard assessment, and exposure scenarios for exposure and risk assessment. Once registered, substances may undergo evaluation by the European Chemicals Agency (ECHA) or Member State authorities and be subject to requests for additional information or testing as well as additional risk reduction measures. To manage the REACH registration and related activities for the European olefins and aromatics industry, the Lower Olefins and Aromatics REACH Consortium was formed in 2008 with administrative and technical support provided by Penman Consulting. A total of 135 substances are managed by this group including 26 individual chemical registrations (e.g. benzene, 1,3-butadiene) and 13 categories consisting of 5-26 substances. This presentation will describe the content of selected registrations prepared for 2010 in addition to the significant post-2010 activities. Beyond REACH, content of the registrations may also be relevant to other European activities, for example consideration of worker DNELs/DMELs for occupational exposure level setting, discussion of this aspect will be presented for 1,3-butadiene.


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