Central obesity as a precursor to the metabolic syndrome in the AusDiab study and Mauritius

Evidence from epidemiologic studies that central obesity precedes future metabolic change and does not occur concurrently with the appearance of the blood pressure, glucose, and lipid abnormalities that characterize the metabolic syndrome (MetS) has been lacking. Longitudinal surveys were conducted in Mauritius in 1987, 1992, and 1998, and in Australia in 2000 and 2005 (AusDiab). This analysis included men and women (aged 25 years) in three cohorts: AusDiab 2000&ndash;2005 (n = 5,039), Mauritius 1987&ndash;1992 (n = 2,849), and Mauritius 1987&ndash;1998 (n = 1,999). MetS components included waist circumference, systolic blood pressure, fasting and 2-h postload plasma glucose, high-density lipoprotein (HDL) cholesterol, triglycerides, and homeostasis model assessment of insulin sensitivity (HOMA-S) (representing insulin sensitivity). Linear regression was used to determine which baseline components predicted deterioration in other MetS components over 5 years in AusDiab and 5 and 11 years in Mauritius, adjusted for age, sex, and ethnic group. Baseline waist circumference predicted deterioration (P &lt; 0.01) in four of the other six MetS variables tested in AusDiab, five of six in Mauritius 1987&ndash;1992, and four of six in Mauritius 1987&ndash;1998. In contrast, an increase in waist circumference between baseline and follow-up was only predicted by insulin sensitivity (HOMA-S) at baseline, and only in one of the three cohorts. These results suggest that central obesity plays a central role in the development of the MetS and appears to precede the appearance of the other MetS components.<br /

Relationships between two dimensions of employee perfectionism, postwork cognitive processing, and work day functioning

This daily diary study examined relations between two distinct perfectionism dimensions and work-related cognitions experienced by employees during evening leisure time. Drawing from perseverative cognitive processing theory, we hypothesized that perfectionistic concerns would be related to work-related worry and rumination during postwork evenings. In contrast, we hypothesized that a theoretically more adaptive perfectionist dimension (perfectionistic strivings) would be associated with positively valenced self-reflections about work across consecutive evenings. A sample of 148 full-time workers completed an initial survey, which included a trait perfectionism measure, reported their work-related cognitions across four consecutive evenings of a working week, rated their sleep quality immediately upon awakening on each subsequent morning, and their daily levels of emotional exhaustion and work engagement at the end of each work day. Results showed that perfectionistic concerns were indirectly negatively associated with sleep quality and work day functioning via the tendency to worry and ruminate about work. In contrast, perfectionistic strivings were indirectly positively associated with work day engagement via the propensity to experience positive thoughts about work during evening leisure time. The theoretical and practical implications of these findings are discussed

Sexual Function in Women Suffering from Aortoiliac Occlusive Disease

AbstractObjective:to describe the sexual function in women suffering aortoiliac occlusive disease (AIOD) and in an age-matched reference group.Patients and methods:thirty-six women suffering from AIOD were included. Twenty were investigated before vascular intervention (untreated) and 16 different women after treatment (treated). Eighteen age-matched women served as areferencegroup. The patients answered a questionnaire including sexual, social and medical questions and a gynaecological examination was performed.Results:untreated patients with AIOD have a significantly impaired physical well-being compared to the other groups (p<0.001). A negative effect of the vascular disease and its treatment on sexual life was experienced by 69% oftreatedcompared to 40% affected amonguntreated(p=0.05). Vulval sensibility was impaired in 44% oftreated, 11% ofuntreatedand 22% ofreferencepatients. Defective anal sphincter function was found in 33% oftreated, 17% ofuntreatedand 6% in thereferencegroup. Those differences were not statistically significant.Conclusions:symptomatic AIOD in women is associated with a significantly impaired physical and sexual well-being. Though limited by size and methodology, the results indicate the possibility of iatrogenic nerve damage

Graph Annotations in Modeling Complex Network Topologies

The coarsest approximation of the structure of a complex network, such as the Internet, is a simple undirected unweighted graph. This approximation, however, loses too much detail. In reality, objects represented by vertices and edges in such a graph possess some non-trivial internal structure that varies across and differentiates among distinct types of links or nodes. In this work, we abstract such additional information as network annotations. We introduce a network topology modeling framework that treats annotations as an extended correlation profile of a network. Assuming we have this profile measured for a given network, we present an algorithm to rescale it in order to construct networks of varying size that still reproduce the original measured annotation profile. Using this methodology, we accurately capture the network properties essential for realistic simulations of network applications and protocols, or any other simulations involving complex network topologies, including modeling and simulation of network evolution. We apply our approach to the Autonomous System (AS) topology of the Internet annotated with business relationships between ASs. This topology captures the large-scale structure of the Internet. In depth understanding of this structure and tools to model it are cornerstones of research on future Internet architectures and designs. We find that our techniques are able to accurately capture the structure of annotation correlations within this topology, thus reproducing a number of its important properties in synthetically-generated random graphs

A Variational Approach for Minimizing Lennard-Jones Energies

A variational method for computing conformational properties of molecules with Lennard-Jones potentials for the monomer-monomer interactions is presented. The approach is tailored to deal with angular degrees of freedom, {\it rotors}, and consists in the iterative solution of a set of deterministic equations with annealing in temperature. The singular short-distance behaviour of the Lennard-Jones potential is adiabatically switched on in order to obtain stable convergence. As testbeds for the approach two distinct ensembles of molecules are used, characterized by a roughly dense-packed ore a more elongated ground state. For the latter, problems are generated from natural frequencies of occurrence of amino acids and phenomenologically determined potential parameters; they seem to represent less disorder than was previously assumed in synthetic protein studies. For the dense-packed problems in particular, the variational algorithm clearly outperforms a gradient descent method in terms of minimal energies. Although it cannot compete with a careful simulating annealing algorithm, the variational approach requires only a tiny fraction of the computer time. Issues and results when applying the method to polyelectrolytes at a finite temperature are also briefly discussed.Comment: 14 pages, uuencoded compressed postscript fil

The effect of microstructure on mechanical properties of HVOF sprayed WC-CoCr composite coatings

This study aims for deeper understanding of the composition and phase changes occurring during HVOF spraying of the powder to WC-CoCr coatings. Also, the effect of lamellar microstructure on the mechanical properties is studied. Compositional and microstructural features are studied by means of X-ray diffraction, XRF, FE-SEM and TEM (EDX, EELS). Mechanical properties are mainly studied by different instrumented indentation and nanoindentation techniques. The use of two new fracture parameters, complementing the fracture toughness value of the coating, are proposed and examined. Higher load range indentations are used to measure cross-sectional and surface hardness, elastic modulus and fracture toughness of the coatings. Mechanical properties of individual phases are studied by nanoindentation. To our knowledge this is the first time that the mechanical properties of this amorphous/nanocrystalline matrix are studied. ICP (In-situ Coating Property) sensor, developed for quality control and residual stress evaluation, is also used to measure the elastic modulus and coefficient of thermal expansion (CTE) of the coatings. Abrasion wear resistance of the coatings are studied according to standard ASTM G 65D. Because of the brittle nature of HVOF coatings, the main focus of this study is in the effects of coating microstructure on fracture toughness, and on crack initiation and propagation resistance. It is shown that even when two similar coatings have equal indentation fracture toughness values, the critical crack initiation loads may be very different. This new parameter is expected to be extremely useful in the evaluation of the coating performance under loading conditions

Complex Langevin Equation and the Many-Fermion Problem

We study the utility of a complex Langevin (CL) equation as an alternative for the Monte Carlo (MC) procedure in the evaluation of expectation values occurring in fermionic many-body problems. We find that a CL approach is natural in cases where non-positive definite probability measures occur, and remains accurate even when the corresponding MC calculation develops a severe ``sign problem''. While the convergence of CL averages cannot be guaranteed in principle, we show how convergent results can be obtained in three examples ranging from simple one-dimensional integrals over quantum mechanical models to a schematic shell model path integral.Comment: 19 pages, 10 PS figures embedded in tex

Characterization of monomeric and soluble aggregated Aβ in Down's syndrome and Alzheimer's disease brains

The major characteristics of Alzheimer's disease (AD) are amyloid plaques, consisting of aggregated beta amyloid (Aβ) peptides, together with tau pathology (tangles, neuropil treads and dystrophic neurites surrounding the plaques), in the brain. Down's syndrome (DS) individuals are at increased risk to develop AD-type pathology; most DS individuals have developed substantial pathology already at the age of 40. DS individuals have an extra copy of chromosome 21, harbouring the amyloid precursor protein gene (APP). Our aim was to investigate the Aβ peptide pattern in DS and AD brains to investigate differences in their amyloid deposition and aggregation, respectively. Cortical tissue from patients with DS (with amyloid pathology), sporadic AD and controls were homogenized and fractionated into TBS (water soluble) and formic acid (water insoluble) fractions. Immunoprecipitation (IP) was performed using a variety of antibodies targeting different Aβ species including oligomeric Aβ. Mass spectrometry was then used to evaluate the presence of Aβ species in the different patient groups. A large number of Aβ peptides were identified including Aβ1-X, 2-X, 3-X, 4-X, 5-X, 11-X, and Aβ peptides extended N terminally of the BACE1 cleavage site and ending at amino 15 in the Aβ sequence APP/Aβ(-X to 15), as well as peptides post-translationally modified by pyroglutamate formation. Most Aβ peptides had higher abundance in AD and DS compared to controls, except the APP/Aβ(-X to 15) peptides which were most abundant in DS followed by controls and AD. Furthermore, the abundancies of AβX-40 and AβX-34 were increased in DS compared with AD. Aβ1-40, Aβ1-42, and Aβ4-42 were identified as the main constitutes of protofibrils (IP'd using mAb158) and higher relative Aβ1-42 signals were obtained compared with samples IP'd with 6E10 + 4G8, indicating that the protofibrils/oligomers were enriched with peptides ending at amino acid 42. All Aβ peptides found in AD were also present in DS indicating similar pathways of Aβ peptide production, degradation and accumulation, except for APP/Aβ(-X to 15). Likewise, the Aβ peptides forming protofibrils/oligomers in both AD and DS were similar, implying the possibility that treatment with clinical benefit in sporadic AD might also be beneficial for subjects with DS

Swedish social insurance officers' experiences of difficulties in assessing applications for disability pensions – an interview study

<p>Abstract</p> <p>Background</p> <p>In this study the focus is on social insurance officers judging applications for disability pensions. The number of applications for disability pension increased during the late 1990s, which has resulted in an increasing number of disability pensions in Sweden. A more restrictive attitude towards the clients has however evolved, as societal costs have increased and governmental guidelines now focus on reducing costs. As a consequence, the quantitative and qualitative demands on social insurance officers when handling applications for disability pensions may have increased. The aim of this study was therefore to describe the social insurance officers' experiences of assessing applications for disability pensions after the government's introduction of stricter regulations.</p> <p>Methods</p> <p>Qualitative methodology was employed and a total of ten social insurance officers representing different experiences and ages were chosen. Open-ended interviews were performed with the ten social insurance officers. Data was analysed with inductive content analysis.</p> <p>Results</p> <p>Three themes could be identified as problematic in the social insurance officers' descriptions of dealing with the applications in order to reach a decision on whether the issue qualified applicants for a disability pension or not: 1. Clients are heterogeneous. 2. Ineffective and time consuming waiting for medical certificates impede the decision process. 3. Perspectives on the issue of work capacity differed among different stakeholders. The backgrounds of the clients differ considerably, leading to variation in the quality and content of applications. Social insurance officers had to make rapid decisions within a limited time frame, based on limited information, mainly on the basis of medical certificates that were often insufficient to judge work capacity. The role as coordinating actor with other stakeholders in the welfare system was perceived as frustrating, since different stakeholders have different goals and demands. The social insurance officers experience lack of control over the decision process, as regulations and other stakeholders restrict their work.</p> <p>Conclusion</p> <p>A picture emerges of difficulties due to disharmonized systems, stakeholder-bound goals causing some clients to fall between two stools, or leading to unnecessary waiting times, which may limit the clients' ability to take an active part in a constructive process. Increased communication with physicians about how to elaborate the medical certificates might improve the quality of certificates and thereby reduce the clients waiting time.</p

Health problems and disability in long-term sickness absence: ICF coding of medical certificates

<p>Abstract</p> <p>Background</p> <p>The purpose of this study was to test the feasibility of International Classification of Functioning, Disability and Health (ICF) and to explore the distribution, including gender differences, of health problems and disabilities as reflected in long-term sickness absence certificates.</p> <p>Methods</p> <p>A total of 433 patients with long sick-listing periods, 267 women and 166 men, were included in the study. All certificates exceeding 28 days of sick-listing sent to the local office of the Swedish Social Insurance Administration of a municipality in the Stockholm area were collected during four weeks in 2004-2005. ICD-10 medical diagnosis codes in the certificates were retrieved and free text information on disabilities in body function, body structure or activity and participation were coded according to ICF short version.</p> <p>Results</p> <p>In 89.8% of the certificates there were descriptions of disabilities that readily could be classified according to ICF. In a reliability test 123/131 (94%) items of randomly chosen free text information were identically classified by two of the authors. On average 2.4 disability categories (range 0-9) were found per patient; the most frequent were 'Sensation of pain' (35.1% of the patients), 'Emotional functions' (34.1%), 'Energy and drive functions' (22.4%), and 'Sleep functions' (16.9%). The dominating ICD-10 diagnostic groups were 'Mental and behavioural disorders' (34.4%) and 'Diseases of the musculoskeletal system and connective tissue' (32.8%). 'Reaction to severe stress and adjustment disorders' (14.7%), and 'Depressive episode' (11.5%) were the most frequent diagnostic codes. Disabilities in mental functions and activity/participation were more commonly described among women, while disabilities related to the musculoskeletal system were more frequent among men.</p> <p>Conclusions</p> <p>Both ICD-10 diagnoses and ICF categories were dominated by mental and musculoskeletal health problems, but there seems to be gender differences, and ICF classification as a complement to ICD-10 could provide a better understanding of the consequences of diseases and how individual patients can cope with their health problems. ICF is feasible for secondary classifying of free text descriptions of disabilities stated in sick-leave certificates and seems to be useful as a complement to ICD-10 for sick-listing management and research.</p