Gravitational energy as dark energy: Concordance of cosmological tests

We provide preliminary quantitative evidence that a new solution to averaging the observed inhomogeneous structure of matter in the universe [gr-qc/0702082, arxiv:0709.0732], may lead to an observationally viable cosmology without exotic dark energy. We find parameters which simultaneously satisfy three independent tests: the match to the angular scale of the sound horizon detected in the cosmic microwave background anisotropy spectrum; the effective comoving baryon acoustic oscillation scale detected in galaxy clustering statistics; and type Ia supernova luminosity distances. Independently of the supernova data, concordance is obtained for a value of the Hubble constant which agrees with the measurement of the Hubble Key team of Sandage et al [astro-ph/0603647]. Best-fit parameters include a global average Hubble constant H_0 = 61.7 (+1.2/-1.1) km/s/Mpc, a present epoch void volume fraction of f_{v0} = 0.76 (+0.12/-0.09), and an age of the universe of 14.7 (+0.7/-0.5) billion years as measured by observers in galaxies. The mass ratio of non-baryonic dark matter to baryonic matter is 3.1 (+2.5/-2.4), computed with a baryon-to-photon ratio that concords with primordial lithium abundances.Comment: 4 pages, 2 figures; v2 improved statistics, references added, to appear in ApJ Letter

Evaluation and optimisation of physical activity in individuals with chronic obstructive pulmonary disease (COPD)

The studies in this thesis evaluated the physical activity (PA) in individuals with chronic obstructive pulmonary disease (COPD), identified strategies to optimise PA, determined the effects of a supervised walking training program on performance during the endurance shuttle walk test (ESWT) and determined the minimal detectable difference for the ESWT.The measurement techniques used included: PA using motion sensors; HRQoL assessment; Fear of Falling Questionnaire, Hospital Anxiety and Depression Scale; and functional exercise testing

Info Kampus UITM Cawangan Sarawak isu 44-feb 05

Assalammualaikum w.b.t dan salam sejahtera.Terlebih dahulu saya bagi pihak warga kampus Uitm Cawangan Sarawak mengucapkan tahniah kepada Pengarah Kampus atas penganugerahan pangkat profesor.Kami semua mendoakan agar Prof sentiasa maju jaya

Accuracy and Responsiveness of the stepwatch activity monitor and ActivPAL in patients with CODP when walking with and without a rollator

Purpose: To evaluate the measurement properties of the StepWatch™ Activity Monitor (SAM) and ActivPAL in COPD. Method: Whilst wearing both monitors, participants performed walking tasks at two self-selected speeds, with and without a rollator. Steps obtained using the monitors were compared with that measured by direct observation. Results: Twenty participants aged 73 ± 9 years (FEV1 = 35 ± 13% pred; 8 males) completed the study. Average speeds for the slow and normal walking tasks were 34 ± 7 m•min−1and 46 ± 10 m•min−1, respectively. Agreement between steps recorded by the SAM with steps counted was similar irrespective of speed or rollator use (p = 0.63) with a mean difference and limit of agreement (LOA) of 2 steps•min−1 and 6 steps•min−1, respectively. Agreement for the ActivPAL was worse at slow speeds (mean difference 7 steps•min−1; LOA 10 steps•min−1) compared with normal speeds (mean difference 4 steps•min−1; LOA 5 steps•min−1) (p = 0.03), but was unaffected by rollator use. The change in step rate between slow and normal walking via direct observation was 12 ± 7 steps•min−1 which was similar to that detected by the SAM (12 ± 6 steps•min−1) and ActivPAL (14 ± 7 steps•min−1). Conclusions: The SAM can be used to detect steps in people who walk very slowly including those who use a rollator. Both devices were sensitive to small changes

The conductivity of dense molecular gas

We evaluate the conductivity tensor for molecular gas at densities ranging from 10^4 to 10^15 cm^-3 for a variety of grain models. The Hall contribution to the conductivity has generally been neglected in treatments of the dynamics of molecular gas. We find that it is not important if only 0.1 micron grains are considered, but for a Mathis-Rumpl-Nordsieck grain-size distribution (with or without PAHs) it becomes important for densities between 10^7 and 10^11 cm^-3. If PAHs are included, this range is reduced to 10^9 -- 10^10 cm^-3. The consequences for the magnetic field evolution and dynamics of dense molecular gas are profound. To illustrate this, we consider the propagation of Alfven waves under these conditions. A linear analysis yields a dispersion relation valid for frequencies below the neutral collision frequencies of the charged species. The dispersion relation shows that there is a pair of circularly polarised modes with distinct propagation speeds and damping rates. We note that the gravitational collapse of dense cloud cores may be substantially modified by the Hall term.Comment: MNRAS accepted; 9 pp incl 8 figs, LaTeX, uses epsf.sty mn.st

Movement Guidelines for Young Children: Engaging Stakeholders to Design Dissemination Strategies in the Hong Kong Early Childhood Education Context

Background Early childhood is a critical period during which patterns of movement behaviors are formed. The World Health Organization had endorsed guidelines for physical activity, sedentary behavior and sleep over a 24-h time period, which had been adopted by the Center for Health Protection of Hong Kong. This paper reports on stakeholder engagements that were conducted to inform the design of strategies to disseminate the guidelines in early childhood education (ECE) settings. Methods Using a mixed-methods study design, we sought to (a) assess the stakeholders\u27 levels of awareness and knowledge of the Hong Kong movement guidelines for young children and (b) identify the factors that influence the uptake of the said guidelines. We conducted an online survey of early childhood education teachers (N =314), twelve focus groups involving teachers (N = 18) and parents (N = 18), and individual interviews of key informants (N = 7) and domestic workers who provide care for preschool-aged children (N = 7). Descriptive statistics were used for the quantitative data, and thematic analysis was performed on the qualitative data using an inductive and semantic approach following a realist framework. Findings Our findings show that teachers were aware of the movement guidelines for young children, but their knowledge of the specific guidelines was deficient; parents and domestic workers had limited awareness and knowledge of the guidelines. Uptake of the movement guidelines is enabled by parent engagement, activities in the ECE centers, home-school cooperation, and community activities for children. The challenges include the time poverty of parents, local curriculum requirements, limited physical spaces, social values, and pandemic-related restrictions. Conclusion We recommend that dissemination strategies in the ECE context should deliver knowledge content and support stakeholders in mitigating the challenges associated with time, space, and social conditions

Evaluation of a School-Based Dissemination of the Movement Guidelines for Young Children in Hong Kong: Study Protocol

Background Healthy movement behaviors in early childhood are believed to track to adulthood, potentially imparting protective benefits against non-communicable diseases. Highlighting the collaborative and complementary roles of parents and educators in promoting health of young children, this study aims to enable parents and teachers to successfully promote healthy movement behaviors in young children. Guidelines for physical activity, sedentary screen time, and sleep of children aged 2 to 6 years will be systematically disseminated to parents and teachers of children enrolled in early childhood education centers (ECECs) in Hong Kong. An evaluation will be conducted to assess the implementation process and the outcomes of the dissemination of said guidelines. Methods The evaluation will include formative and summative components to examine the implementation (i.e., process evaluation) and the outcomes (i.e., outcome evaluation). Participants include teachers, parents, and children from ECECs in Hong Kong. The process evaluation will be guided by the RE-AIM framework (i.e., reach, efficacy, adaptation, implementation, maintenance). Data gathering and analysis will take a mixed-methods triangulation design - convergence model. The outcome evaluation consists of a non-randomized observational study, using quantitative data from questionnaires and accelerometers. The primary outcome to be measured is the extent to which children meet the guidelines for physical activity, sedentary screen time, and sleep; the secondary outcome is teachers’ and parents’ knowledge and awareness of the guidelines. Discussion Young children who engage in healthy movement behaviors are likely to become adults who will have the disposition to engage in behaviors that have protective effects against non-communicable diseases. The findings of this evaluation are expected to contribute to improving the strategies of systems and government agencies that aspire to promote healthy movement behaviors of young children

The combined role of MRI prostate and prostate health index in improving detection of significant prostate cancer in a screening population of Chinese men

Using prostate-specific antigen (PSA) for prostate cancer (PCa) screening led to overinvestigation and overdiagnosis of indolent PCa. We aimed to investigate the value of prostate health index (PHI) and magnetic resonance imaging (MRI) prostate in an Asian PCa screening program. Men aged 50-75 years were prospectively recruited from a community-based PSA screening program. Men with PSA 4.0-10.0 ng ml -1 had PHI result analyzed. MRI prostate was offered to men with PSA 4.0-50.0 ng ml -1. A systematic prostate biopsy was offered to men with PSA 4.0-9.9 ng ml -1 and PHI ≥35, or PSA 10.0-50.0 ng ml -1. Additional targeted prostate biopsy was offered if they had PI-RADS score ≥3. Clinically significant PCa (csPCa) was defined as the International Society of Urological Pathology (ISUP) grade group (GG) ≥2 or ISUP GG 1 with involvement of ≥30% of total systematic cores. In total, 12.8% (196/1536) men had PSA ≥4.0 ng ml -1. Among 194 men with PSA 4.0-50.0 ng ml -1, 187 (96.4%) received MRI prostate. Among them, 28.3% (53/187) had PI-RADS ≥3 lesions. Moreover, 7.0% (107/1536) men were indicated for biopsy and 94.4% (101/107) men received biopsy. Among the men received biopsy, PCa, ISUP GG ≥2 PCa, and csPCa was diagnosed in 42 (41.6%), 24 (23.8%), and 34 (33.7%) men, respectively. Compared with PSA/PHI pathway in men with PSA 4.0-50.0 ng ml -1, additional MRI increased diagnoses of PCa, ISUP GG ≥2 PCa, and csPCa by 21.2% (from 33 to 40), 22.2% (from 18 to 22), and 18.5% (from 27 to 32), respectively. The benefit of additional MRI was only observed in PSA 4.0-10.0 ng ml -1, and the number of MRI needed to diagnose one additional ISUP GG ≥2 PCa was 20 in PHI ≥35 and 94 in PHI &lt;35. Among them, 45.4% (89/196) men with PSA ≥4.0 ng ml -1 avoided unnecessary biopsy with the use of PHI and MRI. A screening algorithm with PSA, PHI, and MRI could effectively diagnose csPCa while reducing unnecessary biopsies. The benefit of MRI prostate was mainly observed in PSA 4.0-9.9 ng ml -1 and PHI ≥35 group. PHI was an important risk stratification step for PCa screening.</p

Disease Management of Early Childhood Caries: ECC Collaborative Project

Until recently, the standard of care for early childhood caries (ECC) has been primarily surgical and restorative treatment with little emphasis on preventing and managing the disease itself. It is now recognized that surgical treatment alone does not address the underlying etiology of the disease. Despite costly surgeries and reparative treatment, the onset and progression of caries are likely to continue. A successful rebalance of risk and protective factors may prevent, slow down, or even arrest dental caries and its progression. An 18-month risk-based chronic disease management (DM) approach to address ECC in preschool children was implemented as a quality improvement (QI) collaborative by seven teams of oral health care providers across the United States. In the aggregate, fewer DM children experienced new cavitation, pain, and referrals to the operating room (OR) for restorative treatment compared to baseline historical controls. The teams found that QI methods facilitated adoption of the DM approach and resulted in improved care to patients and better outcomes overall. Despite these successes, the wide scale adoption and spread of the DM approach may be limited unless health policy and payment reforms are enacted to compensate providers for implementing DM protocols in their practice

Ground-based walking training improves quality of life and exercise capacity in COPD

This study was designed to determine the effect of ground-based walking training on health-related quality of life and exercise capacity in people with chronic obstructive pulmonary disease (COPD). People with COPD were randomised to either a walking group that received supervised, ground-based walking training two to three times a week for 8–10 weeks, or a control group that received usual medical care and did not participate in exercise training. 130 out of 143 participants (mean±SD age 69±8 years, forced expiratory volume in 1 s 43±15% predicted) completed the study. Compared to the control group, the walking group demonstrated greater improvements in the St George’s Respiratory Questionnaire total score (mean difference -6 points (95% CI -10– -2), p<0.003), Chronic Respiratory Disease Questionnaire total score (mean difference 7 points (95% CI 2–11), p<0.01) and endurance shuttle walk test time (mean difference 208 s (95% CI 104–313), p<0.001). This study shows that ground-based walking training is an effective training modality that improves quality of life and endurance exercise capacity in people with COPD