Effect of an isoenergetic traditional Mediterranean diet on apolipoprotein A-I kinetic in men with metabolic syndrome

BACKGROUND: The impact of the Mediterranean diet (MedDiet) on high-density lipoprotein (HDL) kinetics has not been studied to date. The objective of this study was therefore to investigate the effect of the MedDiet in the absence of changes in body weight on apolipoprotein (apo) A-I kinetic in men with metabolic syndrome (MetS). METHODS: Twenty-six men with MetS (NCEP-ATP III) were recruited from the general community. In this fixed sequence study, participants’ diet was first standardized to a control diet reflecting current averages in macronutrient intake in North American men, with all foods and beverages provided under isoenergetic conditions for 5 weeks. Participants were then fed an isoenergetic MedDiet over a subsequent period of 5 weeks to maintain their weight constant. During the last week of each diet, participants received a single bolus dose of [5,5,5-(2)H(3)] (L)-leucine and fasting blood samples were collected at predetermined time points. ApoA-I kinetic was determined by multicompartmental modeling using isotopic enrichment data over time. Data were analyses using MIXED models. RESULTS: The response of HDL-cholesterol (C) to MedDiet was heterogeneous, such that there was no mean change compared with the control diet. Plasma apoA-I concentration (−3.9%) and pool size (−5.3%, both P < 0.05) were significantly lower after MedDiet and apoA-I production rate tended to be reduced (−5.7%, P = 0.07) with no change in apoA-I fractional catabolic rate (FCR, -1.6%, P = 0.64). Participants among whom HDL-C concentrations were increased with MedDiet (responders: mean ∆HDL-C: +9.9 ± 3.2%, N = 11) showed significantly greater reductions in apoA-I FCR and in apoB and very-low-density lipoprotein-triglycerides (VLDL-TG) concentrations (all P < 0.04) than those among whom HDL-C levels were reduced after the MedDiet (non-responders: mean ∆HDL-C: -12.0 ± 3.9%, N = 8). Correlation analysis revealed that only variations in apoA-I FCR (r = -0.48, P = 0.01) and in plasma VLDL-TG (r = −0.45, P = 0.03) concentrations were correlated with the individual HDL-C response to the MedDiet. CONCLUSIONS: Data from this controlled feeding study suggest that the heterogeneous response of HDL-C to MedDiet, in the absence of important weight loss, is primarily related to individual variations in apoA-I FCR and in plasma VLDL-TG concentrations. TRIAL REGISTRATION: ClinicalTrial.gov registration number: NCT0098865

X-Ray Properties of Narrow-Line Seyfert 1 Galaxies with Very Small Broad-Line Widths

Narrow-line Seyfert\,1 galaxies (NLS1s) with very small broad-line widths (say, FWHM(\hb) \la 1200\,\kms) represent the extreme type of Seyfert\,1 galaxies that have small black hole masses (\mbh) and/or high Eddington ratios (\redd). Here we study the X-ray properties of a homogeneously and optically selected sample of 13 such objects, termed as very narrow line Seyfert\,1 galaxies (VNLS1s), using archival \xmm\ data. It is found that the Fe K$\alpha$ emission line is at most weak in these objects. A soft X-ray excess is ubiquitous, with the thermal temperatures falling within a strict range of 0.1--0.2\,keV. Our result highlights the puzzling independence of the thermal temperature by extending the relations to even smaller FWHM(\hb), i.e., smaller \mbh\ ($\sim 10^6$ \msun) and/or higher \redd. The excess emission can be modeled by a range of viable models, though the disk reflection and Comptonization models generally give somewhat better fits over the smeared absorption and the $p$-free models. At the Eddington ratios around unity and above, the X-ray spectral slopes in the 2--10\,keV band are systematically flatter than the Risaliti et al.'s predictions of the relationship with \redd\ suggested previously. Short timescale (1--2 hours) X-ray variability is common, which, together with the variability amplitude computed for some of the objects, are supportive of the scenario that NLS1s are indeed AGN with relatively small \mbh.Comment: 11 figures and 4 table. Accepted for publication in the Astrophysical Journa

Partnering with Patients and Families to Improve Diagnostic Safety through the OurDX Tool: Effects of Race, Ethnicity, and Language Preference

BACKGROUND: Patients and families at risk for health disparities may also be at higher risk for diagnostic errors but less likely to report them. OBJECTIVES: This study aimed to explore differences in race, ethnicity, and language preference associated with patient and family contributions and concerns using an electronic previsit tool designed to engage patients and families in the diagnostic process (DxP). METHODS: Cross-sectional study of 5,731 patients and families presenting to three subspecialty clinics at an urban pediatric hospital May to December 2021 who completed a previsit tool, codeveloped and tested with patients and families. Prior to each visit, patients/families were invited to share visit priorities, recent histories, and potential diagnostic concerns. We used logistic regression to determine factors associated with patient-reported diagnostic concerns. We conducted chart review on a random subset of visits to review concerns and determine whether patient/family contributions were included in the visit note. RESULTS: Participants provided a similar mean number of contributions regardless of patient race, ethnicity, or language preference. Compared with patients self-identifying as White, those self-identifying as Black (odds ratio [OR]: 1.70; 95% confidence interval [CI]: [1.18, 2.43]) or other race (OR: 1.48; 95% CI: [1.08, 2.03]) were more likely to report a diagnostic concern. Participants who preferred a language other than English were more likely to report a diagnostic concern than English-preferring patients (OR: 2.53; 95% CI: [1.78, 3.59]. There were no significant differences in physician-verified diagnostic concerns or in integration of patient contributions into the note based on race, ethnicity, or language preference. CONCLUSION: Participants self-identifying as Black or other race, or those who prefer a language other than English were 1.5 to 2.5 times more likely than their counterparts to report potential diagnostic concerns when proactively asked to provide this information prior to a visit. Actively engaging patients and families in the DxP may uncover opportunities to reduce the risk of diagnostic errors and potential safety disparities

Observational evidence for matter propagation in accretion flows

We study simultaneous X-ray and optical observations of three intermediate polars EX Hya, V1223 Sgr and TV Col with the aim to understand the propagation of matter in their accretion flows. We show that in all cases the power spectra of flux variability of binary systems in X-rays and in optical band are similar to each other and the majority of X-ray and optical fluxes are correlated with time lag <1 sec. These findings support the idea that optical emission of accretion disks, in these binary systems,largely originates as reprocessing of X-ray luminosity of their white dwarfs. In the best obtained dataset of EX Hya we see that the optical lightcurve unambiguously contains some component, which leads the X-ray emission by ~7 sec. We interpret this in the framework of the model of propagating fluctuations and thus deduce the time of travel of the matter from the innermost part of the truncated accretion disk to the white dwarf surface. This value agrees very well with the time expected for matter threaded onto the magnetosphere of the white dwarf to fall to its surface. The datasets of V1223 Sgr and TV Col in general confirm these findings,but have poorer quality.Comment: 7 pages, 6 figures. Accepted for publication in MNRA

Representative sampling and use of HHXRF to characterize lot and sample quality of quartzite at a pyrometallurgical ferrosilicon plant

Material sampling is a critical component in mining and mineral processing industries. Nonetheless, sampling is often considered to be a simple matter and, as such, non-rigorous sampling protocols are often applied. The use of inappropriate methods produces inferior, non-representative estimates of sampling target composition. To address weaknesses in sampling protocols and evaluate the representativeness of collected samples, we performed a feasibility study of the ability of handheld X-ray fluorescence (HHXRF) to achieve a satisfactory characterization of a raw material lot at a pyrometallurgical ferrosilicon plant. Using composite and grab samples, we determined the various sampling error manifestations stemming from the fundamental sampling error, grouping and segregation error, as well as increment delimitation, increment extraction, and increment preparation errors), and performed a first foray determination of optimal sample mass, and estimated the heterogeneity within the sampling target. HHXRF results were compared with the results obtained using laboratory XRF. A first estimate of optimized sample mass for HHXRF was 10 kg, given the large size of crushed quartz blocks used in ferrosilicon plants—roughly cubic, 10 cm per side; accuracy improved with increased sample mass (18% error with a 10 kg sample versus 35% error when using a 1 kg sample). A 10 kg sample is also the mass a technician can realistically transport from the sampling site to the preparation facilities. The main contribution to the global estimation error is from primary sampling. Variographic analysis illustrated a sill equal to the nugget effect, indicating that two adjacent samples are no more similar than two samples separated by larger distance; this suggests equal spatial heterogeneity at all scales larger than the increment mass in the sampling target. Analytically, the HHXRF and desktop XRF results compared very well. Overall, the error associated with our first attempt at field composite sampling was half of that obtained via grab sampling for both the HHXRF and desktop XRF protocols. Relative to conventional analysis based on grab sampling and analysis via desktop XRF, the use of handheld XRF coupled with composite sampling would appear to be a feasible approach for an improved sampling protocol for obtaining fit-for-purpose characterizations of industrial quartzite

Discovery of an active supermassive black hole in the bulge-less galaxy NGC 4561

We present XMM-Newton observations of the Chandra-detected nuclear X-ray source in NGC 4561. The hard X-ray spectrum can be described by a model composed of an absorbed power-law with Gamma= 2.5^{+0.4}_{-0.3}, and column density N_H=1.9^{+0.1}_{-0.2} times 10^{22} atoms cm^{-2}. The absorption corrected luminosity of the source is L(0.2 - 10.0 keV) = 2.5 times 10^{41} ergs s^{-1}, with bolometric luminosity over 3 \times 10^{42} ergs s^{-1}. Based on the spectrum and the luminosity, we identify the nuclear X-ray source in NGC 4561 to be an AGN, with a black hole of mass M_BH > 20,000 solar masses. The presence of a supermassive black hole at the center of this bulge-less galaxy shows that black hole masses are not necessarily related to bulge properties, contrary to the general belief. Observations such as these call into question several theoretical models of BH--galaxy co-evolution that are based on merger-driven BH growth; secular processes clearly play an important role. Several emission lines are detected in the soft X-ray spectrum of the source which can be well parametrized by an absorbed diffuse thermal plasma with non-solar abundances of some heavy elements. Similar soft X-ray emission is observed in spectra of Seyfert 2 galaxies and low luminosity AGNs, suggesting an origin in the circumnuclear plasma.Comment: To appear in Ap

Partnering With Patients and Families Living With Chronic Conditions to Coproduce Diagnostic Safety Through OurDX: A Previsit Online Engagement Tool

OBJECTIVE: Patients and families are key partners in diagnosis, but methods to routinely engage them in diagnostic safety are lacking. Policy mandating patient access to electronic health information presents new opportunities. We tested a new online tool ( OurDX ) that was codesigned with patients and families, to determine the types and frequencies of potential safety issues identified by patients/families with chronic health conditions and whether their contributions were integrated into the visit note. METHODS: Patients/families at 2 US healthcare sites were invited to contribute, through an online previsit survey: (1) visit priorities, (2) recent medical history/symptoms, and (3) potential diagnostic concerns. Two physicians reviewed patient-reported diagnostic concerns to verify and categorize diagnostic safety opportunities (DSOs). We conducted a chart review to determine whether patient contributions were integrated into the note. We used descriptive statistics to report implementation outcomes, verification of DSOs, and chart review findings. RESULTS: Participants completed OurDX reports in 7075 of 18 129 (39%) eligible pediatric subspecialty visits (site 1), and 460 of 706 (65%) eligible adult primary care visits (site 2). Among patients reporting diagnostic concerns, 63% were verified as probable DSOs. In total, probable DSOs were identified by 7.5% of pediatric and adult patients/families with underlying health conditions, respectively. The most common types of DSOs were patients/families not feeling heard; problems/delays with tests or referrals; and problems/delays with explanation or next steps. In chart review, most clinician notes included all or some patient/family priorities and patient-reported histories. CONCLUSIONS: OurDX can help engage patients and families living with chronic health conditions in diagnosis. Participating patients/families identified DSOs and most of their OurDX contributions were included in the visit note

The core fundamental plane of B2 radio galaxies

The photometric, structural and kinematical properties of the centers of elliptical galaxies, harbor important information of the formation history of the galaxies. In the case of non active elliptical galaxies these properties are linked in a way that surface brightness, break radius and velocity dispersion of the core lie on a fundamental plane similar to that found for their global properties. We construct the Core Fundamental Plane (CFP) for a sizeable sample of low redshift radio galaxies and compare it with that of non radio ellipticals. To pursue this aim we combine data obtained from high resolution HST images with medium resolution optical spectroscopy to derive the photometric and kinematic properties of ~40 low redshift radio galaxies. We find that the CFPs of radio galaxies is indistinguishable from that defined by non radio elliptical galaxies of similar luminosity. The characteristics of the CFP of radio galaxies are also consistent (same slope) with those of the Fundamental Plane (FP) derived from the global properties of radio (and non radio) elliptical galaxies. The similarity of CFP and FP for radio and non radio ellipticals suggests that the active phase of these galaxies has minimal effects for the structure of the galaxies.Comment: 8 pages, 4 figures, accepted for publication in Astronomy and Astrophysic

Development and formative evaluation of the e-Health implementation toolkit

&lt;b&gt;Background&lt;/b&gt; The use of Information and Communication Technology (ICT) or e-Health is seen as essential for a modern, cost-effective health service. However, there are well documented problems with implementation of e-Health initiatives, despite the existence of a great deal of research into how best to implement e-Health (an example of the gap between research and practice). This paper reports on the development and formative evaluation of an e-Health Implementation Toolkit (e-HIT) which aims to summarise and synthesise new and existing research on implementation of e-Health initiatives, and present it to senior managers in a user-friendly format.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Results&lt;/b&gt; The content of the e-HIT was derived by combining data from a systematic review of reviews of barriers and facilitators to implementation of e-Health initiatives with qualitative data derived from interviews of "implementers", that is people who had been charged with implementing an e-Health initiative. These data were summarised, synthesised and combined with the constructs from the Normalisation Process Model. The software for the toolkit was developed by a commercial company (RocketScience). Formative evaluation was undertaken by obtaining user feedback. There are three components to the toolkit - a section on background and instructions for use aimed at novice users; the toolkit itself; and the report generated by completing the toolkit. It is available to download from http://www.ucl.ac.uk/pcph/research/ehealth/documents/e-HIT.xls&lt;p&gt;&lt;/p&gt; &lt;b&gt;Conclusions&lt;/b&gt; The e-HIT shows potential as a tool for enhancing future e-Health implementations. Further work is needed to make it fully web-enabled, and to determine its predictive potential for future implementations