Combining GPS, GIS, and Accelerometry: Methodological Issues in the Assessment of Location and Intensity of Travel Behaviors

Background: Global positioning systems (GPS), geographic information systems (GIS), and accelerometers are powerful tools to explain activity within a built environment, yet little integration of these tools has taken place. This study aimed to assess the feasibility of combining GPS, GIS, and accelerometry to understand transport-related physical activity (TPA) in adults. Methods: Forty adults wore an accelerometer and portable GPS unit over 7 consecutive days and completed a demographics questionnaire and 7-day travel log. Accelerometer and GPS data were extracted for commutes to/from workplace and integrated into a GIS database. GIS maps were generated to visually explore physical activity intensity, GPS speeds and routes traveled. Results: GPS, accelerometer, and survey data were collected for 37 participants. Loss of GPS data was substantial due to a range of methodological issues, such as low battery life, signal drop out, and participant noncompliance. Nonetheless, greater travel distances and significantly higher speeds were observed for motorized trips when compared with TPA. Conclusions: Pragmatic issues of using GPS monitoring to understand TPA behaviors and methodological recommendations for future research were identified. Although methodologically challenging, the combination of GPS monitoring, accelerometry and GIS technologies holds promise for understanding TPA within the built environment

Marked long-term decline in ambient CO mixing ratio in SE England, 1997–2014:Evidence of policy success in improving air quality

Atmospheric CO at Egham in SE England has shown a marked and progressive decline since 1997, following adoption of strict controls on emissions. The Egham site is uniquely positioned to allow both assessment and comparison of ‘clean Atlantic background’ air and CO-enriched air downwind from the London conurbation. The decline is strongest (approximately 50ppb per year) in the 1997–2003 period but continues post 2003. A ‘local CO increment’ can be identified as the residual after subtraction of contemporary background Atlantic CO mixing ratios from measured values at Egham. This increment, which is primarily from regional sources (during anticyclonic or northerly winds) or from the European continent (with easterly air mass origins), has significant seasonality, but overall has declined steadily since 1997. On many days of the year CO measured at Egham is now not far above Atlantic background levels measured at Mace Head (Ireland). The results are consistent with MOPITT satellite observations and ‘bottom-up’ inventory results. Comparison with urban and regional background CO mixing ratios in Hong Kong demonstrates the importance of regional, as opposed to local reduction of CO emission. The Egham record implies that controls on emissions subsequent to legislation have been extremely successful in the UK

Global Oncology Research and Training Collaborations Led by the National Cancer Institute (NCI)–Designated Cancer Centers: Results From the 2018 NCI/ASCO Global Oncology Survey of NCI-Designated Cancer Centers

PURPOSE: The National Cancer Institute (NCI)–Designated Cancer Centers (NDCCs) are active in global oncology research and training, leading collaborations that contribute to the evidence to support global cancer control. To better understand global oncology activities led by NDCCs, the National Cancer Institute Center for Global Health (NCI-CGH) collaborated with ASCO to conduct the 2018 NCI/ASCO Global Oncology Survey of NDCCs. METHODS: The 70 NDCCs received a two-part survey that focused on global oncology programs at NDCCs and non–National Institutes of Health (NIH)–funded global oncology projects with an international collaborator led by the NDCCs. Sixty-five NDCCs responded to the survey, and 57 reported non–NIH-funded global oncology projects. Data were cleaned, coded, and analyzed by NCI-CGH staff. RESULTS: Thirty NDCCs (43%) report having a global oncology program, and 538 non–NIH-funded global oncology projects were reported. Of the NDCCs with global oncology programs, 17 report that trainees complete rotations outside the United States, and the same number enroll trainees from low- and middle-income countries (LMICs). In addition, 147 (28%) of the non–NIH-funded projects focused on capacity building or training, the second highest category after research. Of the 30 top project collaborator countries, 17 were LMICs. Compared with the NCI-funded international grant portfolio, non–NIH-funded global oncology projects were more likely to focus on prevention (12% NCI-funded v 20% non–NIH-funded); early detection, diagnosis, and prognosis (23% v 30%); and cancer control, survivorship, and outcomes research (13% v 22%). CONCLUSION: This survey shows that there is a substantial amount of global oncology research and training supported by NDCCs, and much of this is happening in LMICs. Results of the 2018 Global Oncology Survey can be used to foster opportunities for NDCCs to work collaboratively on activities and to share their findings with relevant stakeholders in their LMIC collaborator countries

Landscape of Global Oncology Research and Training at National Cancer Institute-Designated Cancer Centers: Results of the 2018 to 2019 Global Oncology Survey.

PURPOSE: The National Cancer Institute (NCI)-Designated Cancer Centers (NDCCs) are active in global oncology research and training, leading collaborations to support global cancer control. To better understand global oncology activities led by NDCCs, the NCI Center for Global Health collaborated with ASCO to conduct the 2018/2019 NCI/ASCO Global Oncology Survey of NDCCs. METHODS: Seventy NDCCs received a two-part survey that focused on global oncology programs at NDCCs and non-National Institutes of Health (NIH)-funded global oncology projects with an international collaborator led by the NDCCs. Sixty-seven NDCCs responded to the survey. Data were coded and analyzed by NCI-Center for Global Health staff. RESULTS: Thirty-three NDCCs (47%) reported having a global oncology program, and 61 (87%) reported a collective total of 613 non-NIH-funded global oncology projects. Of the NDCCs with global oncology programs, 17 reported that trainees completed rotations outside the United States and the same number enrolled trainees from low- and middle-income countries (LMIC). Primary focus areas of non-NIH-funded projects were research (469 [76.5%]) and capacity building or training (197 [32.1%]). Projects included collaborators from 110 countries; 68 of these were LMIC. CONCLUSION: This survey shows that there is a substantial amount of global oncology research and training conducted by NDCCs and that much of this is happening in LMIC. Trends in these data reflect those in recent literature: The field of global oncology is growing, advancing scientific knowledge, contributing to building research and training capacity in LMIC, and becoming a recognized career path. Results of the 2018 Global Oncology Survey can be used to foster opportunities for NDCCs to work collaboratively on activities and to share their findings with relevant stakeholders in their LMIC collaborator countries

Full recovery of a 13-year-old boy with pediatric Ramsay Hunt syndrome using a shorter course of aciclovir and steroid at lower doses: a case report

<p>Abstract</p> <p>Introduction</p> <p>Reports on children with Ramsay Hunt syndrome are limited in the literature, resulting in uncertainty regarding the clinical manifestations and outcome of this syndrome. Treatment for Ramsay Hunt syndrome is usually with antivirals, although there is no evidence for beneficial effect on the outcome of Ramsay Hunt syndrome in adults (insufficient data on children exists). Here, we report a case of Ramsay Hunt syndrome occurring in a child who inadvertently received a lower dose of aciclovir and steroid administered for shorter than is usual. Our patient made a full recovery.</p> <p>Case presentation</p> <p>A 13-year-old African boy presented to our out-patients department with an inability to move the right side of his face for one week. He had previously been seen by the doctor on call, who prescribed aciclovir 200 mg three times per day and prednisone 20 mg once daily, both orally for five days, with a working diagnosis of Bell's palsy. After commencement of aciclovir-prednisone, while at home, our patient had headache, malaise, altered taste, vomiting after feeds, a ringing sound in his right ear as well as earache and ear itchiness. Additionally, he developed numerous fluid-filled pimples on his right ear. On presentation, a physical examination revealed a right-sided lower motor neuron facial nerve palsy and a healing rash on the right pinna. On direct questioning, our patient admitted having had chicken pox about three months previously. Based on the history and physical examination, Ramsay Hunt syndrome was diagnosed. Our patient was lost to follow-up until 11 months after the onset of illness; at this time, his facial nerve function was normal.</p> <p>Conclusions</p> <p>This case report documents the clinical manifestations and outcome of pediatric Ramsay Hunt syndrome; a condition with few case reports in the literature. In addition, our patient made a full recovery despite inadvertently receiving a lower dose of aciclovir and steroid administered for shorter than is usual.</p

Macrophage Subset Sensitivity to Endotoxin Tolerisation by Porphyromonas gingivalis

Macrophages (MΦs) determine oral mucosal responses; mediating tolerance to commensal microbes and food whilst maintaining the capacity to activate immune defences to pathogens. MΦ responses are determined by both differentiation and activation stimuli, giving rise to two distinct subsets; pro-inflammatory M1- and anti-inflammatory/regulatory M2- MΦs. M2-like subsets predominate tolerance induction whereas M1 MΦs predominate in inflammatory pathologies, mediating destructive inflammatory mechanisms, such as those in chronic P.gingivalis (PG) periodontal infection. MΦ responses can be suppressed to benefit either the host or the pathogen. Chronic stimulation by bacterial pathogen associated molecular patterns (PAMPs), such as LPS, is well established to induce tolerance. The aim of this study was to investigate the susceptibility of MΦ subsets to suppression by P. gingivalis. CD14hi and CD14lo M1- and M2-like MΦs were generated in vitro from the THP-1 monocyte cell line by differentiation with PMA and vitamin D3, respectively. MΦ subsets were pre-treated with heat-killed PG (HKPG) and PG-LPS prior to stimulation by bacterial PAMPs. Modulation of inflammation was measured by TNFα, IL-1β, IL-6, IL-10 ELISA and NFκB activation by reporter gene assay. HKPG and PG-LPS differentially suppress PAMP-induced TNFα, IL-6 and IL-10 but fail to suppress IL-1β expression in M1 and M2 MΦs. In addition, P.gingivalis suppressed NFκB activation in CD14lo and CD14hi M2 regulatory MΦs and CD14lo M1 MΦs whereas CD14hi M1 pro-inflammatory MΦs were refractory to suppression. In conclusion, P.gingivalis selectively tolerises regulatory M2 MΦs with little effect on pro-inflammatory CD14hi M1 MΦs; differential suppression facilitating immunopathology at the expense of immunity

Re-stating the post-political: depoliticization, social inequalities, and city-region growth

This paper argues that city-region building debates and relatedly ‘post-political’ literatures are missing critical perspectives on the state, particularly the state’s continued existence as a social relation and an arena for politics, its role in the regulation of uneven development and the conflicts and struggles that arise from this. The paper brings the state centrally into ‘post-political’ debates via a critical analysis of the interrelationships between depoliticization and neoliberalism. Focusing on Sheffield (South Yorkshire, England) in the context of devolution and deal-making public policy, the paper explores the seemingly consensual visionmaking dynamics of this city region and dissects the tensions around economic governance, welfare austerity and social inequalities to get a handle on the ‘postpolitical’ depoliticized state in, and of, contemporary capitalism

The prevalence of physical activity and sedentary behaviours relative to obesity among adolescents from Al-ahsa, Saudi Arabia: Rural versus urban variations

Purpose. The aims of this study were to explore the lifestyle of young people living in Al-Ahsa Governorate; to investigate differences due to gender, age, school type, and geographical location. Methods. 1270 volunteered youth (15-19 years) completed a self-report questionnaire that contained 47 items relating to patterns of physical activity (PA), sedentary activity, and eating habits. The questionnaire allows the calculation of total energy expenditure in metabolic equivalent (MET-min) values per week. Results. Significant differences in the PA levels of youth were evident with regard to gender, geographical areas, and type of school. Also, normal weight males reported the highest levels of PA compared to overweight and obese. Conclusions. Youth living in rural desert were less physically active than those living in urban or rural farm environments. Youth of "normal" weight were more active than obese. Males were more active than females and PA levels appeared to decline with age. © 2012 Anwar A. Al-Nuaim et al.Published versio

Retention of perampanel in adults with pharmacoresistant epilepsy at a single tertiary care center

RATIONALE: Observational data on antiepileptic drugs (AEDs) inform about their use in clinical practice. We describe our clinical experience with perampanel (PER) in a large UK tertiary epilepsy center. METHODS: Adults initiated on PER between October 2012 and March 2015 were followed until they discontinued PER or 10 September 2016. Data on epilepsy syndrome, duration, seizure types, concomitant and previous AED use, PER dosing, efficacy and side effects were recorded. Efficacy was categorized as temporary or ongoing (at last follow-up) seizure freedom, ≥50% seizure reduction, or other benefit (e.g. No convulsions or daytime seizures). These categories were mutually exclusive except for people with temporary seizure freedom. RESULTS: 391 received a PER prescription, five of whom never took it. No follow-up data were available for ten. 83% had focal epilepsy. People were prescribed PER in addition to 1-7 (Interquartile range [IQR] 2, 2, 3) AEDs and had previously used up to 18 (IQR 5, 7, 10) AEDs. Total exposure was 639patient/years. Retention rates were 60.4% at one year, 48.3% at two years, and 42.7% at three years. 19 (5%) people reported seizure free periods lasting at least six months. A ≥50% reduction in seizures lasting at least six months was reported by 76 people (20%), and marked improvement for ≥6months was seen in 52 (14%). Five (1%) were taken off other AEDs and continued on PER monotherapy for 4-27months. Seizures were aggravated in 57 (15%). Somatic side effects were reported by 197 (52%), mostly CNS. Mood changes, irritability or challenging behavior were reported by 137 (36%). PER was discontinued by 211 (56%) due to adverse effects (39%), inefficacy (26%), or both (35%). No idiosyncratic adverse events were seen. CONCLUSION: PER resulted in some benefit in 40% of those exposed. Adverse effects on mental health and on balance were common and should be discussed with people before initiating PER

Psychometric precision in phenotype definition is a useful step in molecular genetic investigation of psychiatric disorders

Affective disorders are highly heritable, but few genetic risk variants have been consistently replicated in molecular genetic association studies. The common method of defining psychiatric phenotypes in molecular genetic research is either a summation of symptom scores or binary threshold score representing the risk of diagnosis. Psychometric latent variable methods can improve the precision of psychiatric phenotypes, especially when the data structure is not straightforward. Using data from the British 1946 birth cohort, we compared summary scores with psychometric modeling based on the General Health Questionnaire (GHQ-28) scale for affective symptoms in an association analysis of 27 candidate genes (249 single-nucleotide polymorphisms (SNPs)). The psychometric method utilized a bi-factor model that partitioned the phenotype variances into five orthogonal latent variable factors, in accordance with the multidimensional data structure of the GHQ-28 involving somatic, social, anxiety and depression domains. Results showed that, compared with the summation approach, the affective symptoms defined by the bi-factor psychometric model had a higher number of associated SNPs of larger effect sizes. These results suggest that psychometrically defined mental health phenotypes can reflect the dimensions of complex phenotypes better than summation scores, and therefore offer a useful approach in genetic association investigations