279 research outputs found

    Dynamics of copropagating edge states in a multichannel Mach-Zender interferometer

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    We study numerically a multichannel electronic Mach-Zender interferometer, where an orthogonal magnetic field produces edge states. Our time-dependent model is based on the split-step Fourier method and describes the charge carrier as a Gaussian wavepacket of edge states, whose path is defined by split-gate induced potential profiles on the 2DEG at filling factor 2. We analyse a beam splitter with ∼ 50% inter-channel mixing and obtain Aharonov-Bohm oscillations in the transmission probability of the second channel

    Influence of lifestyle habits, nutritional status and insulin resistance in NAFLD

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    Non alcoholic fatty liver disease (NAFLD) is associated with obesity, diabetes and insulin resistance (IR). The aim of our study was to assess the relationship between IR, anthropometry, lifestyle habits, resting energy expenditure (REE) and degree of fatty liver at ultrasound in 48 overweight patients with NAFLD as compared to 24 controls without fatty liver, matched for age. Nutritional status, alcohol intake and physical activity were assessed by skinfold thickness measurements, a 7-day diary, and SenseWear armband (SWA). REE was assessed by both SWA (REE-SWA) and a Vmax metabolic cart (REE-Vmax). Fatty liver was measured by US and the Doppler Power Index was calculated. IR was assessed using the HOMA index. There was significant correlation between waist circumference, HOMA, Doppler power index and fatty liver grade at US. Multivariate analysis showed that alteration of waist circumference, Doppler power index, and HOMA were the major significant predictors of fatty liver. Our data demonstrated a significant association between NAFLD and central adiposity and IR

    Reliability of Multisensor Armband in Estimating Energy Expenditure According to Degree of Obesity

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    Resting energy expenditure (REE) represents the amount of calories required by the body to maintain vital bodyfunctions. One of the most commonly used methods for estimating REE is indirect calorimetry. Recent studies ondifferent populations have validated a highly innovative instrument, the SenseWear® Armband (SWA), which evaluatestotal energy expenditure and, when used in resting conditions, could also evaluate REE. The purpose of this study wasto determine the agreement of the SWA in assessing REE in obese subjects and, see how this agreement varies withdifferent obesity degree.89 obese subjects (59 women and 30 men), with an age range from 35-65 years and body mass index (BMI)34.5 4.5 kg/m2 were studied. REE was measured by IC Sensor Medics Vmax (SM-29N) and by SWA. Fat mass(FM) and fat-free mass (FFM) was determined by anthropometry and bio-impedance measurements. No statisticaldifference was found between REE measured by SWA (1693±276) and REE measured by SM-29N (1627±293). Thetwo methods showed similar assessments (r=0.8, p 35 kg/m2), the agreement decreases (r =0.6 p 35

    Toward Hole-Spin Qubits in Si p -MOSFETs within a Planar CMOS Foundry Technology

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    Hole spins in semiconductor quantum dots represent a viable route for the implementation of electrically controlled qubits. In particular, the qubit implementation based on Si p-MOSFETs offers great potentialities in terms of integration with the control electronics and long-term scalability. Moreover, the future down scaling of these devices will possibly improve the performance of both the classical (control) and quantum components of such monolithically integrated circuits. Here, we use a multiscale approach to simulate a hole-spin qubit in a down-scaled Si-channel p-MOSFET, the structure of which is based on a commercial 22-nm fully depleted silicon-on-insulator device. Our calculations show the formation of well-defined hole quantum dots within the Si channel and the possibility of a general electrical control, with Rabi frequencies of the order of 100MHz for realistic field values. A crucial role of the channel aspect ratio is also demonstrated, as well as the presence of a favorable parameter range for the qubit manipulation

    Socioeconomic deprivation, urban-rural location and alcohol-related mortality in England and Wales

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    Background: Many causes of death are directly attributable to the toxic effects of alcohol and deaths from these causes are increasing in the United Kingdom. The aim of this study was to investigate variation in alcohol-related mortality in relation to socioeconomic deprivation, urban-rural location and age within a national context. Methods: An ecological study design was used with data from 8797 standard table wards in England and Wales. The methodology included using the Carstairs Index as a measure of socioeconomic deprivation at the small-area level and the national harmonised classification system for urban and rural areas in England and Wales. Alcohol-related mortality was defined using the National Statistics definition, devised for tracking national trends in alcohol-related deaths. Deaths from liver cirrhosis accounted for 85% of all deaths included in this definition. Deaths from 1999-2003 were examined and 2001 census ward population estimates were used as the denominators. Results: The analysis was based on 28,839 deaths. Alcohol-related mortality rates were higher in men and increased with increasing age, generally reaching peak levels in middle-aged adults. The 45-64 year age group contained a quarter of the total population but accounted for half of all alcohol-related deaths. There was a clear association between alcohol-related mortality and socioeconomic deprivation, with progressively higher rates in more deprived areas. The strength of the association varied with age. Greatest relative inequalities were seen amongst people aged 25-44 years, with relative risks of 4.73 (95% CI 4.00 to 5.59) and 4.24 (95% CI 3.50 to 5.13) for men and women respectively in the most relative to the least deprived quintiles. People living in urban areas experienced higher alcohol-related mortality relative to those living in rural areas, with differences remaining after adjustment for socioeconomic deprivation. Adjusted relative risks for urban relative to rural areas were 1.35 (95% CI 1.20 to 1.52) and 1.13 (95% CI 1.01 to 1.25) for men and women respectively. Conclusions: Large inequalities in alcohol-related mortality exist between sub-groups of the population in England and Wales. These should be considered when designing public health policies to reduce alcohol-related harm

    Clinical update on non-alcoholic fatty liver disease and steatohepatitis

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    clusion of less common causes of fatty liver such as Hepatitis B or C infection, drugs and autoimmune disorders, fatty liver is classified as non-alcoholic (NAFLD) or alcoholic fatty liver disease (AFLD) on the basis of daily ethanol intake. The agreed threshold of ethanol intake used to separate NAFLD from AFLD is 20 g/day, equivalent to 12 drinks per week. 2 The term NAFLD covers a wide spectrum of liver injury, ranging from simple steatosis, i.e. fatty infiltration of hepatocytes > 5%, to non-alcoholic steatohepatitis (NASH). At liver biopsy NASH is characterized by necro-inflammation and/or fibrosis, and is histologically indistinguishable from alcoholic steatohepatitis. The histological classification of NAFLD and NASH is being continuously improved and a refined scoring system has been recently proposed by the National Institutes of Health. 3 NAFLD is presently regarded as the most common liver disease in Western countries and virtually impacts all fields of clinical medicine, being considered a risk factor for advanced liver disease, type 2 diabetes and cardiovascular disease. Although NAFLD had long been recognized as a frequent clinical entity, only recently its importance as a potential cause of progressive and severe liver disease has been fully acknowledged. NAFLD prevalence in the general population ranges from 16 to 25% in adults 4 and from 10 to 19% in children. 5 It increases with age, shows different gender specificity according to geographic areas (generally more prevalent in women in US and viceversa in men in Europe and Japan) and varies with ethnicity, with the highest prevalence among the Hispanic population and the lowest among the AfroAmerican one. 6 Prevalence rates of NAFLD are strikingly increased in certain subpopulations, such as patients with obesity, type 2 diabetes mellitus and dyslipidemia, and the whole spectrum of NAFLD is commonly associated with the metabolic syndrome. The true prevalence of NASH remains largely unknown. According to data derived from autopsy or liver biopsy studies, about 10-15% of NAFLD patients meet the current diagnostic criteria for NASH, pointing to a prevalence of 2-3% in the general population. The incidence and natural course of NAFLD are also difficult to assess because most of the available studies are retrospective and/or performed on clinical series. The few prospective studies are too short to exclude late complications. While simple steatosis has a benign prognosis, NASH may progress to cirrhosis in 30% of cases and is responsible for liver-related death in 3-8%. In clinical series, up to 70% of patients with cryptogenic cirrhosis have clinical features suggestive of NASH.

    Associations between overweight and obesity and risk factors for cardiovascular disease and fatty liver in young offenders serving community orders

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    Purpose: The health of young offenders supervised in the community has not been previously studied. This paper describes the prevalence of overweight, obesity and obesity associated cardiovascular and hepatic risk factors in a sample of young offenders supervised in the community in New South Wales, Australia. Methods: During 2003-2005, 802 (85% male) young offenders took part in a comprehensive health survey that included direct measurement of height and weight as well as blood sampling. Results: The prevalence of combined overweight and obesity was 33.7% in boys and 35.3% in girls; both rates were higher than those of a comparable community sample. Cardiovascular risk factor prevalence was extremely high compared with other published studies, with over 90% of boys and almost 80% of girls having low levels of HDL cholesterol, and over 40% of both boys and girls having elevated LDL cholesterol. Risk factors for fatty liver disease were also prevalent with almost 15% of boys, and 30% of girls having raised ALT suggesting hepatic cell injury. Cardiovascular and fatty liver disease risk factors were significantly associated with overweight and obesity among boys, but not girls in this sample. Young people of Aboriginal or Torres Strait Islander decent were at no greater risk than the rest of the population. Conclusions: Young offenders are among the most disadvantaged people in Australian society and are particularly vulnerable to a range of health problems. The high prevalence of risk factors represents a substantial health burden for these young people in early adulthood. Timely intervention is required to address the complex health needs of this under-served population

    Should patients with abnormal liver function tests in primary care be tested for chronic viral hepatitis: cost minimisation analysis based on a comprehensively tested cohort

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    Background Liver function tests (LFTs) are ordered in large numbers in primary care, and the Birmingham and Lambeth Liver Evaluation Testing Strategies (BALLETS) study was set up to assess their usefulness in patients with no pre-existing or self-evident liver disease. All patients were tested for chronic viral hepatitis thereby providing an opportunity to compare various strategies for detection of this serious treatable disease. Methods This study uses data from the BALLETS cohort to compare various testing strategies for viral hepatitis in patients who had received an abnormal LFT result. The aim was to inform a strategy for identification of patients with chronic viral hepatitis. We used a cost-minimisation analysis to define a base case and then calculated the incremental cost per case detected to inform a strategy that could guide testing for chronic viral hepatitis. Results Of the 1,236 study patients with an abnormal LFT, 13 had chronic viral hepatitis (nine hepatitis B and four hepatitis C). The strategy advocated by the current guidelines (repeating the LFT with a view to testing for specific disease if it remained abnormal) was less efficient (more expensive per case detected) than a simple policy of testing all patients for viral hepatitis without repeating LFTs. A more selective strategy of viral testing all patients for viral hepatitis if they were born in countries where viral hepatitis was prevalent provided high efficiency with little loss of sensitivity. A notably high alanine aminotransferase (ALT) level (greater than twice the upper limit of normal) on the initial ALT test had high predictive value, but was insensitive, missing half the cases of viral infection. Conclusions Based on this analysis and on widely accepted clinical principles, a "fast and frugal" heuristic was produced to guide general practitioners with respect to diagnosing cases of viral hepatitis in asymptomatic patients with abnormal LFTs. It recommends testing all patients where a clear clinical indication of infection is present (e.g. evidence of intravenous drug use), followed by testing all patients who originated from countries where viral hepatitis is prevalent, and finally testing those who have a notably raised ALT level (more than twice the upper limit of normal). Patients not picked up by this efficient algorithm had a risk of chronic viral hepatitis that is lower than the general population
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