Experience and expectations of patients on weight loss: The Learning Health System Network Experience

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/152010/1/osp4364_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/152010/2/osp4364.pd

Late Pleistocene and Holocene transgression inferred from the sediments of the Gulf of San Jorge, central Patagonia, Argentina

This study presents the first detailed description of the upper sedimentary succession of the late Pleistocene and Holocene deposits in the Gulf of San Jorge (Patagonia) based on several hundred kilometers of high-resolution seismic (sparker) profiles and numerous sediment cores. High-resolution seismic stratigraphy confirms the existence of a paleo-fluvial network formed during sea-level lowstands and buried by central basin estuarine deposits during the last marine transgression. Analyses of lithostratigraphy and radiocarbon ages indicate the onset of subtidal sedimentation at ~14 cal ka bp. Before the onset of subtidal conditions, the first steps of marine incursion seem to have led to the development of lagoonal/wind–tidal flat environments, advocating for a sea-level stillstand. An abrupt increase in the log(Ti/Ca) ratio in a distinct multi-centimeter-thick layer and the identification of a wave-ravinement surface suggest rapid sea-level rise in the gulf prior to ~14 cal ka bp, consistent with Meltwater Pulse 1A. Overall, this study highlights the significant impact of sea-level rise on sedimentation in the gulf from the onset of marine incursions to the mid-Holocene, as well as the reduced contribution, as currently observed, of riverine inputs due to the progressive diminution and withdrawal of glacial drainage starting before the Holocene. -- Keywords : elemental geochemistry ; incised valleys ; MWP-1A ; Patagonia ; postglacial sea-level changes

Sismoestratigrafía y evolución cenozoica de un sector de las terrazas Nágera y Perito Moreno, Margen Continental Patagónico.

El Margen Continental Patagónico (MCP) es, desde un punto de vista geológico, la porción del Margen Continental Argentino Pasivo Volcánico (MCAPV) ubicada al sur de la Zona de la Fractura Colorado. Esta zona del margen se encuentra influenciada desde el límite Eoceno-Oligoceno, por la circulación termohalina de las corrientes de agua profundas generadas en el sector antártico. La erosión y depositación producida por estas corrientes dio origen a la formación de cuatro extensas terrazas contorníticas que cubren una gran parte del MCP. El objetivo de este trabajo es aportar nuevos conocimientos sobre las dos terrazas más occi- dentales, la Terraza Nágera (TN, ~600 a 1000 m de profundidad) y la Terra- za Perito Moreno (TPM, ~1000 a 1500 m de profundidad). En estas terrazas la sismoestratigrafía y los procesos asociados a su evolución no han sido estudiados en forma exhaustiva. Por tal motivo, los trabajos realizados en la zona se refieren a las edades de las unidades sísmicas en forma especulativa o proponen una sola unidad denominada “post-rift indefinido”. Tras el análisis integrado de un perfil sísmico de mediana resolución y gran pene- tración, y perfiles sísmicos de alta resolución y baja penetración, se han definido una serie de unidades sísmicas, las cuales fueron correlacionadas con esquemas sismoestratigráficos propuestos previamente para el MCAPV, e información bioes- tratigráfica publicada. De este modo se presenta en este trabajo un esquema sismoestratigráfico novedoso para la parte más boreal de la TN y la TPM, el cual se acopla de forma armoniosa a los modelos sismoestratigráficos propuestos para el resto del MCAPV. A partir de las unidades sísmicas definidas se proponen cuatro etapas evolutivas para el Cenozoico de la zona de estudio: 1) Desde el Paleoceno al Eoceno-Oligoceno, se caracteriza por una subsidencia principalmente termal y una sedimentación hemipelágica y gravitacional con poca o nula actividad de corrientes oceánicas. 2) Desde el Eoceno-Oligoceno al Mioceno tardío, se caracteriza por la presencia de un ambiente marino somero, con clinoformas que llegan desde la plataforma externa hasta el talud medio y es interpretada como una progradación deltaica asociada a un estadío de nivel de mar bajo. 3) Desde el Mioceno tardío al Plioceno, caracterizada por las primeras evidencias de acción de corrientes oceánicas, seguido de una superficie erosiva y formación de la TN y la TPM. 4) Desde el Plioceno a la actualidad, se caracteriza por alta actividad de las corrientes oceánicas en el talud superior y medio, intensa interacción entre corrientes oceánicas y el lecho marino y desarrollo de depósitos contorníticos

Text messaging: an innovative method of data collection in medical research

BACKGROUND: The ubiquitous use of mobile phones in sending and receiving text messages has become a norm for young people. Undeniably, text messaging has become a new and important communication medium not only in the social realm but in education as well. The aim of this study is to evaluate the effectiveness of using text messaging as a means to collect data for a medical research project.A cross sectional study was carried out during a double blind, randomized controlled trial to assess the efficacy and safety of a probiotic in the management of Irritable Bowel Syndrome (IBS). The study aim was to assess the response rate of weekly symptom reports via Short Message Service (SMS). The subjects were undergraduates in a private medical university in Malaysia. They were identified through a previous university wide study as suffering from IBS based on Rome III criteria. The subjects were randomly assigned to either the treatment arm receiving a daily probiotic, or the placebo arm. They were required to score their symptoms using eight-item-questionnaires at baseline, and thereafter weekly, for a total of 8 weeks. All subjects were given the choice to communicate their symptom scores by text messaging via mobile phones or by email. SMS text messages were sent to remind trial subjects to attend face-to-face visits and to complete a paper based 34-item-questionnaires on IBS quality of life assessment at baseline and at end of 8 weeks. FINDINGS: The response rate of weekly symptom scores via Short Message Service (SMS) from a total of 38 subjects was 100%. Through the study, 342 reports were submitted: 33.3% of these were received on the due date without reminder, 60.0% one day after the deadline, after a single reminder, 6.1% 2-3 days after the deadline, after 2-3 reminders and 0.6% 5 days after the deadline, after SMS, phone reminder and face-to-face encounter. All SMS symptom reports, whether on time or late, were complete. With the help of SMS reminder, all trial subjects completed the paper based IBS quality of life assessment at baseline and at end of study. CONCLUSIONS: This study found using text messaging via mobile phone an excellent instrument for collecting weekly symptom reports in response to trial medication, reminding trial subjects to attend face to face visits and completing more complex paper based evaluation. The 100% response rate of weekly symptom reports was facilitated by using simple number codes for SMS submission

OxPhos defects cause hypermetabolism and reduce lifespan in cells and in patients with mitochondrial diseases

Patients with primary mitochondrial oxidative phosphorylation (OxPhos) defects present with fatigue and multi-system disorders, are often lean, and die prematurely, but the mechanistic basis for this clinical picture remains unclear. By integrating data from 17 cohorts of patients with mitochondrial diseases (n = 690) we find evidence that these disorders increase resting energy expenditure, a state termed hypermetabolism. We examine this phenomenon longitudinally in patient-derived fibroblasts from multiple donors. Genetically or pharmacologically disrupting OxPhos approximately doubles cellular energy expenditure. This cell-autonomous state of hypermetabolism occurs despite near-normal OxPhos coupling efficiency, excluding uncoupling as a general mechanism. Instead, hypermetabolism is associated with mitochondrial DNA instability, activation of the integrated stress response (ISR), and increased extracellular secretion of age-related cytokines and metabokines including GDF15. In parallel, OxPhos defects accelerate telomere erosion and epigenetic aging per cell division, consistent with evidence that excess energy expenditure accelerates biological aging. To explore potential mechanisms for these effects, we generate a longitudinal RNASeq and DNA methylation resource dataset, which reveals conserved, energetically demanding, genome-wide recalibrations. Taken together, these findings highlight the need to understand how OxPhos defects influence the energetic cost of living, and the link between hypermetabolism and aging in cells and patients with mitochondrial diseases

Outcome reporting in randomised controlled trials and meta-analyses of appendicitis treatments in children: a systematic review

Background: Acute appendicitis is the most common surgical emergency in children. Despite this, there is no core outcome set (COS) described for randomised controlled trials (RCTs) in children with appendicitis and hence no consensus regarding outcome selection, definition and reporting. We aimed to identify outcomes currently reported in studies of paediatric appendicitis. / Methods: Using a defined, sensitive search strategy, we identified RCTs and systematic reviews (SRs) of treatment interventions in children with appendicitis. Included studies were all in English and investigated the effect of one or more treatment interventions in children with acute appendicitis or undergoing appendicectomy for presumed acute appendicitis. Studies were reviewed and data extracted by two reviewers. Primary (if defined) and all other outcomes were recorded and assigned to the core areas ‘Death’, ‘Pathophysiological Manifestations’, ‘Life Impact’, ‘Resource Use’ and ‘Adverse Events’, using OMERACT Filter 2.0. / Results: A total of 63 studies met the inclusion criteria reporting outcomes from 51 RCTs and nine SRs. Only 25 RCTs and four SRs defined a primary outcome. A total of 115 unique and different outcomes were identified. RCTs reported a median of nine outcomes each (range 1 to 14). The most frequently reported outcomes were wound infection (43 RCTs, nine SRs), intra-peritoneal abscess (41 RCTs, seven SRs) and length of stay (35 RCTs, six SRs) yet all three were reported in just 25 RCTs and five SRs. Common outcomes had multiple different definitions or were frequently not defined. Although outcomes were reported within all core areas, just one RCT and no SR reported outcomes for all core areas. Outcomes assigned to the ‘Death’ and ‘Life Impact’ core areas were reported least frequently (in six and 15 RCTs respectively). / Conclusions: There is a wide heterogeneity in the selection and definition of outcomes in paediatric appendicitis, and little overlap in outcomes used across studies. A paucity of studies report patient relevant outcomes within the ‘Life Impact’ core area. These factors preclude meaningful evidence synthesis, and pose challenges to designing prospective clinical trials and cohort studies. The development of a COS for paediatric appendicitis is warranted

Determinants of urinary albumin excretion within the normal range in patients with type 2 diabetes: the Randomised Olmesartan and Diabetes Microalbuminuria Prevention (ROADMAP) study

In contrast to microalbuminuric type 2 diabetic patients, the factors correlated with urinary albumin excretion are less well known in normoalbuminuric patients. This may be important because even within the normoalbuminuric range, higher rates of albuminuria are known to be associated with higher renal and cardiovascular risk. At the time of screening for the Randomised Olmesartan and Diabetes Microalbuminuria Prevention (ROADMAP) Study, the urinary albumin/creatinine ratio (UACR) was 0.44 mg/mmol in 4,449 type 2 diabetic patients. The independent correlates of UACR were analysed. Independent correlates of UACR during baseline were (in descending order): night-time systolic BP (r (s) = 0.19); HbA(1c) (r (s) = 0.18); mean 24 h systolic BP (r (s) = 0.16); fasting blood glucose (r (s) = 0.16); night-time diastolic BP (r (s) = 0.12); office systolic BP, sitting (r (s) = 0.11), standing (r (s) = 0.10); estimated GFR (r (s) = 0.10); heart rate, sitting (r (s) = 0.10); haemoglobin (r (s) = -0.10); triacylglycerol (r (s) = 0.09); and uric acid (r (s) = -0.08; all p a parts per thousand currency signaEuro parts per thousand 0.001). Significantly higher albumin excretion rates were found for the following categorical variables: higher waist circumference (more marked in men); presence of the metabolic syndrome; smoking (difference more marked in males); female sex; antihypertensive treatment; use of amlodipine; insulin treatment; family history of diabetes; and family history of cardiovascular disease (more marked in women). Although observational correlations do not prove causality, in normoalbuminuric type 2 diabetic patients the albumin excretion rate is correlated with many factors that are potentially susceptible to intervention. ClinicalTrials.gov ID no.: NCT00185159 This study was sponsored by Daichii-Sankyo.Nephrolog

Effective Rheology of Bubbles Moving in a Capillary Tube

We calculate the average volumetric flux versus pressure drop of bubbles moving in a single capillary tube with varying diameter, finding a square-root relation from mapping the flow equations onto that of a driven overdamped pendulum. The calculation is based on a derivation of the equation of motion of a bubble train from considering the capillary forces and the entropy production associated with the viscous flow. We also calculate the configurational probability of the positions of the bubbles.Comment: 4 pages, 1 figur

Measurement of the inclusive and dijet cross-sections of b-jets in pp collisions at sqrt(s) = 7 TeV with the ATLAS detector

The inclusive and dijet production cross-sections have been measured for jets containing b-hadrons (b-jets) in proton-proton collisions at a centre-of-mass energy of sqrt(s) = 7 TeV, using the ATLAS detector at the LHC. The measurements use data corresponding to an integrated luminosity of 34 pb^-1. The b-jets are identified using either a lifetime-based method, where secondary decay vertices of b-hadrons in jets are reconstructed using information from the tracking detectors, or a muon-based method where the presence of a muon is used to identify semileptonic decays of b-hadrons inside jets. The inclusive b-jet cross-section is measured as a function of transverse momentum in the range 20 < pT < 400 GeV and rapidity in the range |y| < 2.1. The bbbar-dijet cross-section is measured as a function of the dijet invariant mass in the range 110 < m_jj < 760 GeV, the azimuthal angle difference between the two jets and the angular variable chi in two dijet mass regions. The results are compared with next-to-leading-order QCD predictions. Good agreement is observed between the measured cross-sections and the predictions obtained using POWHEG + Pythia. MC@NLO + Herwig shows good agreement with the measured bbbar-dijet cross-section. However, it does not reproduce the measured inclusive cross-section well, particularly for central b-jets with large transverse momenta.Comment: 10 pages plus author list (21 pages total), 8 figures, 1 table, final version published in European Physical Journal