Long-term trends in BMI: are contemporary childhood BMI growth references appropriate when looking at historical datasets?

Background Body mass index (BMI) is the most widely used surrogate measure of adiposity, and BMI z-scores are often calculated when comparing childhood BMI between populations and population sub-groups. Several growth references are currently used as the basis for calculation of such z-scores, for both contemporary cohorts as well as cohorts born decades ago. Due to the widely acknowledged increases in childhood obesity over recent years it is generally assumed that older birth cohorts would have lower BMIs relative to the current standards. However, this reasonable assumption has not been formally tested.   Methods Two growth references (1990 UK and 2000 CDC) are used to calculate BMI z-scores in three historical British national birth cohorts (National Survey of Health and Development (1958), National Child Development Study (1958) and British Cohort Study (1970)). BMI z-scores are obtained for each child at each follow-up age using the lambda-mu-sigma (LMS) method, and their distributions examined.   Results Across all three cohorts, median BMI z-score at each follow-up age is observed to be positive in early childhood. This is contrary to what might have been expected given the assumed temporal increase in childhood BMI. However, z-scores then decrease and become negative during adolescence, before increasing once more.   Conclusions The differences in BMI distribution between the historical cohorts and the contemporary growth references appear systematic and similar across the cohorts. This might be explained by contemporary reference data describing a faster tempo of weight increase relative to height than observed in older birth cohorts. Comparisons using z-scores over extended periods of time should therefore be interpreted with caution

Multiple measures are needed to quantify training loads in professional rugby league

To investigate the effect of training mode (conditioning and skills) on multivariate training load relationships in professional rugby league via principal component analysis. Four measures of training load (internal: heart rate exertion index, session rating of perceived exertion; external: PlayerLoad™, individualised high-speed distance) were collected from 23 professional male rugby league players over the course of one 12-wk preseason period. Training was categorised by mode (skills or conditioning) and then subjected to a principal component analysis. Extraction criteria were set at an eigenvalue of greater than 1. Modes that extracted more than 1 principal component were subject to a Varimax rotation. Skills extracted 1 principal component, explaining 57% of the variance. Conditioning extracted 2 principal components (1st: internal; 2nd: external), explaining 85% of the variance. The presence of multiple training load dimensions (principal components) during conditioning training provides further evidence of the influence of training mode on the ability of individual measures of external or internal training load to capture training variance. Consequently, a combination of internal- and external- training load measures is required during certain training modes

Factors associated with excess all-cause mortality in the first wave of the COVID-19 pandemic in the UK: A time series analysis using the Clinical Practice Research Datalink

BACKGROUND: Excess mortality captures the total effect of the Coronavirus Disease 2019 (COVID-19) pandemic on mortality and is not affected by misspecification of cause of death. We aimed to describe how health and demographic factors were associated with excess mortality during, compared to before, the pandemic. METHODS AND FINDINGS: We analysed a time series dataset including 9,635,613 adults (≥40 years old) registered at United Kingdom general practices contributing to the Clinical Practice Research Datalink. We extracted weekly numbers of deaths and numbers at risk between March 2015 and July 2020, stratified by individual-level factors. Excess mortality during Wave 1 of the UK pandemic (5 March to 27 May 2020) compared to the prepandemic period was estimated using seasonally adjusted negative binomial regression models. Relative rates (RRs) of death for a range of factors were estimated before and during Wave 1 by including interaction terms. We found that all-cause mortality increased by 43% (95% CI 40% to 47%) during Wave 1 compared with prepandemic. Changes to the RR of death associated with most sociodemographic and clinical characteristics were small during Wave 1 compared with prepandemic. However, the mortality RR associated with dementia markedly increased (RR for dementia versus no dementia prepandemic: 3.5, 95% CI 3.4 to 3.5; RR during Wave 1: 5.1, 4.9 to 5.3); a similar pattern was seen for learning disabilities (RR prepandemic: 3.6, 3.4 to 3.5; during Wave 1: 4.8, 4.4 to 5.3), for black or South Asian ethnicity compared to white, and for London compared to other regions. Relative risks for morbidities were stable in multiple sensitivity analyses. However, a limitation of the study is that we cannot assume that the risks observed during Wave 1 would apply to other waves due to changes in population behaviour, virus transmission, and risk perception. CONCLUSIONS: The first wave of the UK COVID-19 pandemic appeared to amplify baseline mortality risk to approximately the same relative degree for most population subgroups. However, disproportionate increases in mortality were seen for those with dementia, learning disabilities, non-white ethnicity, or living in London

Student and staff perceptions and experiences of the introduction of Objective Structured Practical Examinations: A pilot study

Background. The Objective Structured Practical Examination (OSPE) is widely recognised as one of the more objective methods of assessing practical skills in healthcare programmes, including undergraduate physiotherapy curricula.Objectives. To obtain feedback from both students and staff who were involved in the introduction of an OSPE in 2011, in order to refine and standardise the format throughout the curriculum.Methods. A qualitative research design was used. Data were gathered through a questionnaire with semi-structured open-ended items and focus group discussion. Participants were all third-year undergraduate physiotherapy students (N=47) and all staff members (N=10) in the 2011 academic year who were exposed to the OSPE format or were involved in the first OSPE.Results. The main concerns raised by both students and staff were: (i) pressure due to time constraints and how this might affect student performance; and (ii) the question of objectivity during the assessment. However, their initial concerns changed as they experienced the OSPE in a more positive manner owing to the structure and objectivity of the process of implementing the OSPE.Conclusion. While both students and staff reported positive experiences, the challenges that emerged provided valuable insight in terms of refining the OSPE format in this undergraduate physiotherapy department

Fermentation kinetics including product and substrate inhibitions plus biomass death: a mathematical analysis

Fermentation is generally modelled by kinetic equations giving the time evolutions for biomass, substrate, and product concentrations. Although these equations can be solved analytically in simple cases if substrate/product inhibition and biomass death are included, they are typically solved numerically. We propose an analytical treatment of the kinetic equations --including cell death and an arbitrary number of inhibitions-- in which constant yield needs not be assumed. Equations are solved in phase space, i.e. the biomass concentration is written explicitly as a function of the substrate concentration.Comment: 4 pages, 4 figure

Understanding cohort differences in appraisals of reconstruction priorities of mental health systems in postconflict Liberia

Objective: This study analyzes the relationship between informants’ age and their assessment of mental health needs in postconflict society and examines if mental health needs assessment priorities differ depending upon whether or not the informant was exposed to the Liberian civil war.Method: A cross-sectional survey was conducted in March 2009 to obtain data on mental health needs of Liberian children, adolescents and young adults. A total of 171 individuals were interviewed. The data were analyzed using a two- way ANOVA.Results: Elder respondents expressed a preference for young adults to receive services in a church/mosque (F = 4.020, p < .05); for adolescents in volunteer programs (F = 3.987, p < .05) and for children in sports programs (F = 4.396, p < .05). Experiencing conflict did exert some influence on treatment setting preferences. Those who resided outside Liberia during the conflict cited a preference for traditional healers and medical clinics. However, this preference was for the children and young adult age categories. Those who experienced the civil war reported significantly higher preferences for adolescent services to be located in medical clinics, with traditional healers, and in churches/mosques.Conclusion: This study provides additional support for the premise that the utilization of psychiatric services needs to be viewed from the perspective of Liberians and that there are differences in preferences across groups. Our results suggest that service providers and policy makers take into account the age of the patient when deciding where to locate treatment settings for the population.Keywords: Mental Health; Liberia; Treatment Settings; Elders; Needs AssessmentAfrican Journal of Psychiatry • November 2013, 16(6

β-Arrestin-2 regulates the development of allergic asthma

Asthma is a chronic inflammatory disorder of the airways that is coordinated by Th2 cells in both human asthmatics and animal models of allergic asthma. Migration of Th2 cells to the lung is key to their inflammatory function and is regulated in large part by chemokine receptors, members of the seven-membrane-spanning receptor family. It has been reported recently that T cells lacking β-arrestin-2, a G protein-coupled receptor regulatory protein, demonstrate impaired migration in vitro. Here we show that allergen-sensitized mice having a targeted deletion of the β-arrestin-2 gene do not accumulate T lymphocytes in their airways, nor do they demonstrate other physiological and inflammatory features characteristic of asthma. In contrast, the airway inflammatory response to LPS, an event not coordinated by Th2 cells, is fully functional in mice lacking β-arrestin-2. β-arrestin-2-deficient mice demonstrate OVA-specific IgE responses, but have defective macrophage-derived chemokine-mediated CD4+ T cell migration to the lung. This report provides the first evidence that β-arrestin-2 is required for the manifestation of allergic asthma. Because β-arrestin-2 regulates the development of allergic inflammation at a proximal step in the inflammatory cascade, novel therapies focused on this protein may prove useful in the treatment of asthma

Three "universal" mesoscopic Josephson effects

1. Introduction 2. Supercurrent from Excitation Spectrum 3. Excitation Spectrum from Scattering Matrix 4. Short-Junction Limit 5. Universal Josephson Effects 5.1 Quantum Point Contact 5.2 Quantum Dot 5.3 Disordered Point Contact (Average supercurrent, Supercurrent fluctuations)Comment: 21 pages, 2 figures; legacy revie

Stochastic Gravity: Theory and Applications

Whereas semiclassical gravity is based on the semiclassical Einstein equation with sources given by the expectation value of the stress-energy tensor of quantum fields, stochastic semiclassical gravity is based on the Einstein-Langevin equation, which has in addition sources due to the noise kernel. In the first part, we describe the fundamentals of this new theory via two approaches: the axiomatic and the functional. In the second part, we describe three applications of stochastic gravity theory. First, we consider metric perturbations in a Minkowski spacetime, compute the two-point correlation functions of these perturbations and prove that Minkowski spacetime is a stable solution of semiclassical gravity. Second, we discuss structure formation from the stochastic gravity viewpoint. Third, we discuss the backreaction of Hawking radiation in the gravitational background of a black hole and describe the metric fluctuations near the event horizon of an evaporating black holeComment: 100 pages, no figures; an update of the 2003 review in Living Reviews in Relativity gr-qc/0307032 ; it includes new sections on the Validity of Semiclassical Gravity, the Stability of Minkowski Spacetime, and the Metric Fluctuations of an Evaporating Black Hol