The Supplemental Impact of Telephone-Based Lifestyle Modification Counseling in an Outpatient Weight Loss Clinic

Abstract Purpose: The purpose of the project is to implement effective, convenient, and efficient weight loss counseling in today’s fast-paced mobile society. The project will reinforce current physical activity guidelines in correlation with the clinic’s standard dietary guidelines and pharmacological interventions. Patient adherence and motivation will be supported through lifestyle modification counseling via telephone. Background: The prevalence of obese adults in the United States (US) increased from 33.7 percent in 2007-2008 to 39.6 percent in 2015-2016. Abnormal or excess weight gain may further impair health, as it correlates with the development of multiple preventable comorbidities such as cardiovascular disease, diabetes mellitus, and some cancers such as breast cancer or colon cancer. Overweight and obese patient’s pose a significant health care burden. Total costs attributable to the obese and overweight population is predicted to double every decade costing about $860.7-$956.9 billion by 2030, accounting for 16-18 percent of total US health care costs (Mobley & Baum, 2015). According to the CDC, (2018), the prevalence of obesity accounts for more than one-third (36.5 percent) of overweight and obese adults in the US, and further claims that in 2008 the estimated annual medical cost in the US attributed to obesity was $147 billion. Practice Change: Three mandatory telephonic reminders were added to each patient’s weight loss plan on day three, day seven, and week six of the program. Outcomes: Implementation of telephone-based intensive lifestyle modification counseling as an evidence-based intervention is a valuable method to improve weight loss outcomes, enhance clinical efficiency, maintain safety, and increase patient satisfaction. Conclusion: Early detection, diagnosis, and management of overweight or obese patients are vital to prevent morbidity, mortality, improve quality of life, and prolong life expectancy without suffering. Evidence-based interventions are key to help facilitate healthy weight loss goals and reduce both patient and health care system costs

Real time dynamic strain monitoring of optical links using the backreflection of live PSK data.

A major cause of faults in optical communication links is related to unintentional third party intrusions (normally related to civil/agricultural works) causing fiber breaks or cable damage. These intrusions could be anticipated and avoided by monitoring the dynamic strain recorded along the cable. In this work, a novel technique is proposed to implement real-time distributed strain sensing in parallel with an operating optical communication channel. The technique relies on monitoring the Rayleigh backscattered light from optical communication data transmitted using standard modulation formats. The system is treated as a phase-sensitive OTDR (ΦOTDR) using random and non-periodical non-return-to-zero (NRZ) phase-shift keying (PSK) pulse coding. An I/Q detection unit allows for a full (amplitude, phase and polarization) characterization of the backscattered optical signal, thus achieving a fully linear system in terms of ΦOTDR trace coding/decoding. The technique can be used with different modulation formats, and operation using 4 Gbaud single-polarization dual PSK and 4 Gbaud dual-polarization quadrature PSK is demonstrated. As a proof of concept, distributed sensing of dynamic strain with a sampling of 125 kHz and a spatial resolution of 2.5 cm (set by the bit size) over 500 m is demonstrated for applied sinusoidal strain signals of 500 Hz. The limitations and possibilities for improvement of the technique are also discussed.This work was supported by the European Research Council through Starting Grant UFINE (Grant no. 307441), the Spanish MINECO through project TEC2013-45265-R, PCIN-2015- 219, and the regional program SINFOTON-CM: S2013/MIT-2790. HFM acknowledges EU funding through the FP7 ITN ICONE program, gr. #608099. SML acknowledges funding from the Spanish MINECO through a “Ramon y Cajal” contract. UK EPSRC funding through project EP/J008842/1

Addressing the Rates of Contaminated Blood Cultures in the TJUH ED

Background & Aim Blood culture contamination is a common, yet underrecognized, adverse event within emergency departments (ED). Through root cause analysis, this project identified barriers to using standardized blood culture collection techniques in the TJUH (Thomas Jefferson University Hospital) ED. After incorporating our proposed interventions, we aim to reduce the percentage of contaminated blood cultures t

BSE can propagate in sheep co-infected or pre-infected with scrapie

To understand the possible role of mixed-prion infections in disease presentation, the current study reports the co-infection of sheep with bovine spongiform encephalopathy (BSE) and scrapie. The bovine BSE agent was inoculated subcutaneously into sheep with ARQ/ARQ or VRQ/ARQ PRNP genotypes either at the same time as subcutaneous challenge with scrapie, or three months later. In addition, VRQ/VRQ sheep naturally infected with scrapie after being born into a scrapie-affected flock were challenged subcutaneously with BSE at eight or twenty one months-of-age. Sheep were analysed by incubation period/attack rate, and western blot of brain tissue determined the presence of BSE or scrapie-like PrP Sc. Serial protein misfolding cyclic amplification (sPMCA) that can detect very low levels of BSE in the presence of an excess of scrapie agent was also applied to brain and lymphoreticular tissue. For VRQ/ARQ sheep challenged with mixed infections, scrapie-like incubation periods were produced, and no BSE agent was detected. However, whilst ARQ/ARQ sheep developed disease with BSE-like incubation periods, some animals had a dominant scrapie western blot phenotype in brain, but BSE was detected in these sheep by sPMCA. In addition, VRQ/VRQ animals challenged with BSE after natural exposure to scrapie had scrapie-like incubation periods and dominant scrapie PrP Sc in brain, but one sheep had BSE detectable by sPMCA in the brain. Overall, the study demonstrates for the first time that for scrapie/BSE mixed infections, VRQ/ARQ sheep with experimental scrapie did not propagate BSE but VRQ/VRQ sheep with natural scrapie could propagate low levels of BSE, and whilst BSE readily propagated in ARQ/ARQ sheep it was not always the dominant PrP Sc strain in brain tissue. Indeed, for several animals, a dominant scrapie biochemical phenotype in brain did not preclude the presence of BSE prion

Lepton flavour violation in the MSSM

We derive new constraints on the quantities delta_{XY}^{ij}, X,Y=L,R, which parametrise the flavour-off-diagonal terms of the charged slepton mass matrix in the MSSM. Considering mass and anomalous magnetic moment of the electron we obtain the bound |delta^{13}_{LL} delta^{13}_{RR}|<0.1 for tan beta=50, which involves the poorly constrained element delta^{13}_{RR}. We improve the predictions for the decays tau -> mu gamma, tau -> e gamma and mu -> e gamma by including two-loop corrections which are enhanced if tan beta is large. The finite renormalisation of the PMNS matrix from soft SUSY-breaking terms is derived and applied to the charged-Higgs-lepton vertex. We find that the experimental bound on BR(tau -> e gamma) severely limits the size of the MSSM loop correction to the PMNS element U_{e3}, which is important for the proper interpretation of a future U_{e3} measurement. Subsequently we confront our new values for delta^{ij}_{LL} with a GUT analysis. Further, we include the effects of dimension-5 Yukawa terms, which are needed to fix the Yukawa unification of the first two generations. If universal supersymmetry breaking occurs above the GUT scale, we find the flavour structure of the dimension-5 Yukawa couplings tightly constrained by mu -> e gamma.Comment: 37 pages, 15 figures; typo in Equation (35) and (49) correcte

Activated Magnetospheres of Magnetars

Like the solar corona, the external magnetic field of magnetars is twisted by surface motions of the star. The twist energy is dissipated over time. We discuss the theory of this activity and its observational status. (1) Theory predicts that the magnetosphere tends to untwist in a peculiar way: a bundle of electric currents (the "j-bundle") is formed with a sharp boundary, which shrinks toward the magnetic dipole axis. Recent observations of shrinking hot spots on magnetars are consistent with this behavior. (2) Continual discharge fills the j-bundle with electron-positron plasma, maintaining a nonthermal corona around the neutron star. The corona outside a few stellar radii strongly interacts with the stellar radiation and forms a "radiatively locked" outflow with a high e+- multiplicity. The locked plasma annihilates near the apexes of the closed magnetic field lines. (3) New radiative-transfer simulations suggest a simple mechanism that shapes the observed X-ray spectrum from 0.1 keV to 1 MeV: part of the thermal X-rays emitted by the neutron star are reflected from the outer corona and then upscattered by the inner relativistic outflow in the j-bundle, producing a beam of hard X-rays.Comment: 23 pages, 7 figures; review chapter in the proceedings of ICREA Workshop on the High-Energy Emission from Pulsars and Their Systems, Sant Cugat, Spain, April 201

Interplay of LFV and slepton mass splittings at the LHC as a probe of the SUSY seesaw

We study the impact of a type-I SUSY seesaw concerning lepton flavour violation (LFV) both at low-energies and at the LHC. The study of the di-lepton invariant mass distribution at the LHC allows to reconstruct some of the masses of the different sparticles involved in a decay chain. In particular, the combination with other observables renders feasible the reconstruction of the masses of the intermediate sleptons involved in $\chi_2^0\to \tilde \ell \,\ell \to \ell \,\ell\,\chi_1^0$ decays. Slepton mass splittings can be either interpreted as a signal of non-universality in the SUSY soft breaking-terms (signalling a deviation from constrained scenarios as the cMSSM) or as being due to the violation of lepton flavour. In the latter case, in addition to these high-energy processes, one expects further low-energy manifestations of LFV such as radiative and three-body lepton decays. Under the assumption of a type-I seesaw as the source of neutrino masses and mixings, all these LFV observables are related. Working in the framework of the cMSSM extended by three right-handed neutrino superfields, we conduct a systematic analysis addressing the simultaneous implications of the SUSY seesaw for both high- and low-energy lepton flavour violation. We discuss how the confrontation of slepton mass splittings as observed at the LHC and low-energy LFV observables may provide important information about the underlying mechanism of LFV.Comment: 50 pages, 42 eps Figures, typos correcte

The transcriptional response of Caenorhabditis elegans to ivermectin exposure identifies novel genes involved in the response to reduced food intake

We have examined the transcriptional response of Caenorhabditis elegans following exposure to the anthelmintic drug ivermectin (IVM) using whole genome microarrays and real-time QPCR. Our original aim was to identify candidate molecules involved in IVM metabolism and/or excretion. For this reason the IVM tolerant strain, DA1316, was used to minimise transcriptomic changes related to the phenotype of drug exposure. However, unlike equivalent work with benzimidazole drugs, very few of the induced genes were members of xenobiotic metabolising enzyme families. Instead, the transcriptional response was dominated by genes associated with fat mobilization and fatty acid metabolism including catalase, esterase, and fatty acid CoA synthetase genes. This is consistent with the reduction in pharyngeal pumping, and consequential reduction in food intake, upon exposure of DA1316 worms to IVM. Genes with the highest fold change in response to IVM exposure, cyp-37B1, mtl-1 and scl-2, were comparably up-regulated in response to short–term food withdrawal (4 hr) independent of IVM exposure, and GFP reporter constructs confirm their expression in tissues associated with fat storage (intestine and hypodermis). These experiments have serendipitously identified novel genes involved in an early response of C. elegans to reduced food intake and may provide insight into similar processes in higher organisms

Inherited germline TP53 mutation encodes a protein with an aberrant C-terminal motif in a case of pediatric adrenocortical tumor

Childhood adrenocortical tumor (ACT), a very rare malignancy, has an annual worldwide incidence of about 0.3 per million children younger than 15 years. The association between inherited germline mutations of the TP53 gene and an increased predisposition to ACT was described in the context of the Li-Fraumeni syndrome. In fact, about two-thirds of children with ACT have a TP53 mutation. However, less than 10% of pediatric ACT cases occur in Li-Fraumeni syndrome, suggesting that inherited low-penetrance TP53 mutations play an important role in pediatric adrenal cortex tumorigenesis. We identified a novel inherited germline TP53 mutation affecting the acceptor splice site at intron 10 in a child with an ACT and no family history of cancer. The lack of family history of cancer and previous information about the carcinogenic potential of the mutation led us to further characterize it. Bioinformatics analysis showed that the non-natural and highly hydrophobic C-terminal segment of the frame-shifted mutant p53 protein may disrupt its tumor suppressor function by causing misfolding and aggregation. Our findings highlight the clinical and genetic counseling dilemmas that arise when an inherited TP53 mutation is found in a child with ACT without relatives with Li-Fraumeni-component tumors

Decreased transcription-coupled nucleotide excision repair capacity is associated with increased p53- and MLH1-independent apoptosis in response to cisplatin

Abstract Background One of the most commonly used classes of anti-cancer drugs presently in clinical practice is the platinum-based drugs, including cisplatin. The efficacy of cisplatin therapy is often limited by the emergence of resistant tumours following treatment. Cisplatin resistance is multi-factorial but can be associated with increased DNA repair capacity, mutations in p53 or loss of DNA mismatch repair capacity. Methods RNA interference (RNAi) was used to reduce the transcription-coupled nucleotide excision repair (TC-NER) capacity of several prostate and colorectal carcinoma cell lines with specific defects in p53 and/or DNA mismatch repair. The effect of small inhibitory RNAs designed to target the CSB (Cockayne syndrome group B) transcript on TC-NER and the sensitivity of cells to cisplatin-induced apoptosis was determined. Results These prostate and colon cancer cell lines were initially TC-NER proficient and RNAi against CSB significantly reduced their DNA repair capacity. Decreased TC-NER capacity was associated with an increase in the sensitivity of tumour cells to cisplatin-induced apoptosis, even in p53 null and DNA mismatch repair-deficient cell lines. Conclusion The present work indicates that CSB and TC-NER play a prominent role in determining the sensitivity of tumour cells to cisplatin even in the absence of p53 and DNA mismatch repair. These results further suggest that CSB represents a potential target for cancer therapy that may be important to overcome resistance to cisplatin in the clinic