Independent and combined effects of aerobic and resistance training on blood pressure (ART-B)

The health benefits of aerobic exercise have been well established, with less data existing on the benefits of resistance exercise. Furthermore, most early studies on physical activity and hypertension investigated either aerobic or resistance training alone, and have primarily been done on healthy individuals. Therefore, data on individuals who are hypertensive, overweight or obese, sedentary, and at an increased risk for cardiovascular disease are scarce. Purpose: The purpose of this study was to compare the effects of aerobic training only, resistance training only, and a combination of both on blood pressure and other cardiovascular disease risk factors compared with a non-exercising control group. Methods: Pre- or stage-1 hypertensive, overweight or obese, and sedentary men and women (ages 58 ± 7 years) were randomized to one of three 8-week exercise programs (aerobic only, resistance only, or a combination of both), or a non-exercise control group. The exercise programs were all 3 days per week for 1 hour. Results: Of the 69 randomized participants, 66 completed the protocol and all 69 were used in an intention-to-treat analysis. At baseline, the mean (SE) for systolic and diastolic blood pressure was 131 (13) mmHg and 91 (9) mmHg, respectively. Eight weeks of exercise did not significantly change systolic blood pressure in any of the groups (p \u3e 0.05), and only the combination group saw a significant decrease in diastolic blood pressure (-3.7 mmHg, 95% CI -6.8, -0.6). Significant increases [mean (95% CI); p value] were also seen in treadmill time for the aerobic [72 seconds (38, 107); p \u3c0.01] and combination groups [51 seconds (17, 86); p \u3c0.01], whereas significant lower body strength gains were seen in the resistance [29.4 lbs (9.1, 49.7); p=0.01] and combination groups [24.4 lbs (4.7, 44.2); p=0.02]. Lastly, significant improvements [mean (95% CI; p value)] in body composition were seen for all three exercise groups: aerobic [weight: -1.0 kg (-1.9, -0.1; p=0.03) and fat mass -0.9 kg (-1.5, -0.2; p=0.01)], resistance [waist circumference: -1.7 cm (-3.3, -0.1; p=0.04)], and combination [weight 0.9 kg (0.02, 1.8; p=0.04) and lean body mass 0.8 kg (0.0, 1.5; p=0.04)]. Conclusion: Overall, the combination of aerobic and resistance exercise training seemed to be the most effective in improving blood pressure and other cardiovascular disease risk factors

Effect of Preanalytical Processing of ThinPrep Specimens on Detection of High-Risk Human Papillomavirus by the Aptima HPV Assay

Two important preanalytical protocols performed on liquid-based cytological specimens, namely, automated cytology processing and glacial acetic acid (GAA) treatment, may occur prior to the arrival of specimens in a molecular diagnostics laboratory. Ninety-two ThinPrep vials previously positive for high-risk human papillomavirus (HPV) via the Cervista HPV HR test were preselected and alternated with 92 previously negative ThinPrep vials. The specimen set was processed in a consecutive fashion by an automated cytology processor without fastidious decontamination precautions. Carryover potential was subsequently assessed by performance of the Aptima HPV assay on aliquots from reprocessed ThinPrep vials. All previously negative ThinPrep vials yielded a negative result following routine automated cytology processing, despite close proximity to known-positive ThinPrep vials. In separate experiments, aliquots from 236 ThinPrep vials were forwarded for tandem analysis with and without GAA treatment. Data from GAA- and mock-treated specimens generated by Aptima HPV were compared to correlate data generated by Cervista. A 99.2% concordance of Aptima HPV results from GAA-treated and mock-treated specimens was noted. This result differed from the concordance result derived from Cervista (91.5%; P \u3c 0.0002). Of the initially positive Cervista results, 21.9% reverted to negative following GAA treatment; the correlate value was 2.7% for Aptima HPV (P = 0.01). While deleterious effects of GAA treatment on genomic DNA were noted with Cervista (P = 0.0015), GAA treatment had no significant effects on Aptima HPV specimen signal/cutoff ratios or amplification of internal control RNA (P ≥ 0.07). The validity of an Aptima HPV result is independent of GAA treatment and routine automated cytology processing

Associations of Health Club Membership with Physical Activity and Cardiovascular Health

Introduction This study evaluates whether a health club membership is associated with meeting the US physical activity (PA) guidelines and/or favorable cardiovascular health. Methods Using cross-sectional data of health club members (n = 204) and non-members (n = 201) from April to August 2013, this is the first study to our knowledge to examine a health club membership in relation to objectively measured cardiovascular health indicators including resting blood pressure, resting heart rate, body mass index, waist circumference, and cardio respiratory fitness based on a non-exercise test algorithm. To determine the total PA and sedentary time, this study used a comprehensive PA questionnaire about both aerobic and resistance activities at the health club, as well as lifestyle activities in other settings, which was developed based on the International Physical Activity Questionnaire (IPAQ). Results The odds ratios (95% confidence interval) of meeting either the aerobic, resistance, or both aerobic and resistance PA guidelines for members compared to non-members were 16.5 (9.8–27.6), 10.1 (6.2–16.3), and 13.8 (8.5–22.4), respectively. Significant associations of health club membership with more favorable cardiovascular health outcomes and sedentary behavior were observed for resting heart rate (B: -4.8 b/min, p\u3c0.001), cardiorespiratory fitness (B: 2.1 ml/kg/min, p\u3c0.001), and sedentary time (B: -1.4 hours, p\u3c0.001). Participants with a health club membership of \u3e1 year had more favorable health outcomes, with a smaller waist circumference (men, B: -4.0 cm, p = 0.04; women, B: -3.4 cm, p = 0.06), compared to non-members. Conclusions Health club membership is associated with significantly increased aerobic and resistance physical activity levels and more favorable cardiovascular health outcomes compared to non-members. However, longitudinal, randomized controlled trials would be clearly warranted as cross-sectional data prohibits causal inferences

Geochemical and Strontium Isotope Characterization of Produced Waters from Marcellus Shale Natural Gas Extraction

Extraction of natural gas by hydraulic fracturing of the Middle Devonian Marcellus Shale, a major gas-bearing unit in the Appalachian Basin, results in significant quantities of produced water containing high total dissolved solids (TDS). We carried out a strontium (Sr) isotope investigation to determine the utility of Sr isotopes in identifying and quantifying the interaction of Marcellus Formation produced waters with other waters in the Appalachian Basin in the event of an accidental release, and to provide information about the source of the dissolved solids. Strontium isotopic ratios of Marcellus produced waters collected over a geographic range of ∼375 km from southwestern to northeastern Pennsylvania define a relatively narrow set of values (εSr SW = +13.8 to +41.6, where εSr SW is the deviation of the 87Sr/86Sr ratio from that of seawater in parts per 104); this isotopic range falls above that of Middle Devonian seawater, and is distinct from most western Pennsylvania acid mine drainage and Upper Devonian Venango Group oil and gas brines. The uniformity of the isotope ratios suggests a basin-wide source of dissolved solids with a component that is more radiogenic than seawater. Mixing models indicate that Sr isotope ratios can be used to sensitively differentiate between Marcellus Formation produced water and other potential sources of TDS into ground or surface waters

Global Emergency Medicine: A Review of the Literature From 2012

Objectives The Global Emergency Medicine Literature Review ( GEMLR ) conducts an annual search of peer‐reviewed and grey literature relevant to global emergency medicine ( EM ) to identify, review, and disseminate the most important new research in this field to a worldwide audience of academics and clinical practitioners. Methods This year, our search identified 4,818 articles written in six languages. These articles were distributed among 20 reviewers for initial screening based on their relevance to the field of global EM . Two additional reviewers searched and screened the grey literature. A total of 224 articles were deemed appropriate by at least one reviewer and were approved by their editor for formal scoring of overall quality and importance. Results Of the 224 articles that met our predetermined inclusion criteria, 56% were categorized as Emergency Care in Resource‐limited Settings, 18% as EM development, and 26% as Disaster and Humanitarian Response. A total of 28 articles received scores of 16 or higher and were selected for formal summary and critique. Inter‐rater reliability for two reviewers using our scoring system was good, with an intraclass correlation coefficient of 0.625 (95% confidence interval = 0.512 to 0.711). Conclusions In 2012 there were more disaster and humanitarian response articles than in previous years. As in prior years, the majority of articles addressed the acute management of infectious diseases or the care of vulnerable populations such as children and pregnant women. Resumen Medicina de Urgencias y Emergencias Global: Una Revisión de la Literatura de 2012 Objetivos La revisión de la literatura publicada en Medicina de Urgencias y Emergencias ( MUE ) global comporta una búsqueda anual de los trabajos relevantes para la MUE global, tanto publicados tras revisión por pares como corresponedientes a literatura gris. La finalidad es identificar, revisar y diseminar las investigaciones novedosas más importantes en este campoa médicos clínicos y universitarios de todo el mundo. Metodología Este año, nuestra búsqueda identificó 4.818 artículos escritos en seis lenguas. Estos artículos se distribuyeron entre 20 revisores para el despistaje inicial basándose en su relevancia para el campo de la MUE global. Dos revisores adicionales buscaron y filtraron la literatura gris. Un total de 224 artículos se consideraron apropiados por al menos un revisor, y se aprobaron por su editor para la puntuación formal de la calidad e importancia totales. Resultados De los 224 artículos que cumplieron nuestros criterios de inclusión predeterminados, un 56% se clasificaron como atención de urgencias y emergencias en ámbitos de recursos limitados, un 18% como desarrollo de la MUE y un 26% como catástrofes y respuesta humanitaria. Un total de 28 artículos recibieron una puntuación de 16 o más y se seleccionaron para el resumen y la crítica formal. La fiabilidad interobservador para los 2 revisores usando nuestro sistema de puntuación fue buena, con un coeficiente de correlación intraclase de 0,625 ( IC 95% = 0,512 a 0,711). Conclusiones En 2012 hubo más artículos sobre catástrofes y respuesta humanitaria que en años anteriores. Como en los años previos, la mayoría de los artículos valoraron el manejo agudo de enfermedades infecciosas o la atención de poblaciones vulnerables como los niños y las mujeres embarazadas.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/99685/1/acem12173.pd

An unbiased assessment of the role of imprinted genes in an intergenerational model of developmental programming.

Environmental factors during early life are critical for the later metabolic health of the individual and of future progeny. In our obesogenic environment, it is of great socioeconomic importance to investigate the mechanisms that contribute to the risk of metabolic ill health. Imprinted genes, a class of functionally mono-allelic genes critical for early growth and metabolic axis development, have been proposed to be uniquely susceptible to environmental change. Furthermore, it has also been suggested that perturbation of the epigenetic reprogramming of imprinting control regions (ICRs) may play a role in phenotypic heritability following early life insults. Alternatively, the presence of multiple layers of epigenetic regulation may in fact protect imprinted genes from such perturbation. Unbiased investigation of these alternative hypotheses requires assessment of imprinted gene expression in the context of the response of the whole transcriptome to environmental assault. We therefore analyse the role of imprinted genes in multiple tissues in two affected generations of an established murine model of the developmental origins of health and disease using microarrays and quantitative RT-PCR. We demonstrate that, despite the functional mono-allelicism of imprinted genes and their unique mechanisms of epigenetic dosage control, imprinted genes as a class are neither more susceptible nor protected from expression perturbation induced by maternal undernutrition in either the F1 or the F2 generation compared to other genes. Nor do we find any evidence that the epigenetic reprogramming of ICRs in the germline is susceptible to nutritional restriction. However, we propose that those imprinted genes that are affected may play important roles in the foetal response to undernutrition and potentially its long-term sequelae. We suggest that recently described instances of dosage regulation by relaxation of imprinting are rare and likely to be highly regulated

Synergistic drug combinations from electronic health records and gene expression.

ObjectiveUsing electronic health records (EHRs) and biomolecular data, we sought to discover drug pairs with synergistic repurposing potential. EHRs provide real-world treatment and outcome patterns, while complementary biomolecular data, including disease-specific gene expression and drug-protein interactions, provide mechanistic understanding.MethodWe applied Group Lasso INTERaction NETwork (glinternet), an overlap group lasso penalty on a logistic regression model, with pairwise interactions to identify variables and interacting drug pairs associated with reduced 5-year mortality using EHRs of 9945 breast cancer patients. We identified differentially expressed genes from 14 case-control human breast cancer gene expression datasets and integrated them with drug-protein networks. Drugs in the network were scored according to their association with breast cancer individually or in pairs. Lastly, we determined whether synergistic drug pairs found in the EHRs were enriched among synergistic drug pairs from gene-expression data using a method similar to gene set enrichment analysis.ResultsFrom EHRs, we discovered 3 drug-class pairs associated with lower mortality: anti-inflammatories and hormone antagonists, anti-inflammatories and lipid modifiers, and lipid modifiers and obstructive airway drugs. The first 2 pairs were also enriched among pairs discovered using gene expression data and are supported by molecular interactions in drug-protein networks and preclinical and epidemiologic evidence.ConclusionsThis is a proof-of-concept study demonstrating that a combination of complementary data sources, such as EHRs and gene expression, can corroborate discoveries and provide mechanistic insight into drug synergism for repurposing