Small portion sizes in worksite cafeterias: do they help consumers to reduce their food intake?

Background:Environmental interventions directed at portion size might help consumers to reduce their food intake.Objective:To assess whether offering a smaller hot meal, in addition to the existing size, stimulates people to replace their large meal with a smaller meal.Design:Longitudinal randomized controlled trial assessing the impact of introducing small portion sizes and pricing strategies on consumer choices.Setting/participants:In all, 25 worksite cafeterias and a panel consisting of 308 consumers (mean age39.18 years, 50% women).Intervention:A small portion size of hot meals was offered in addition to the existing size. The meals were either proportionally priced (that is, the price per gram was comparable regardless of the size) or value size pricing was employed.Main outcome measures:Daily sales of small and the total number of meals, consumers self-reported compensation behavior and frequency of purchasing small meals.Results:The ratio of small meals sales in relation to large meals sales was 10.2%. No effect of proportional pricing was found B0.11 (0.33), P0.74, confidence interval (CI): 0.76 to 0.54). The consumer data indicated that 19.5% of the participants who had selected a small meal often-to-always purchased more products than usual in the worksite cafeteria. Small meal purchases were negatively related to being male (B0.85 (0.20), P0.00, CI: 1.24 to 0.46, n178).Conclusion:When offering a small meal in addition to the existing size, a percentage of consumers that is considered reasonable were inclined to replace the large meal with the small meal. Proportional prices did not have an additional effect. The possible occurrence of compensation behavior is an issue that merits further attention. © 2011 Macmillan Publishers Limited All rights reserved

Cosmic shear analysis of archival HST/ACS data: I. Comparison of early ACS pure parallel data to the HST/GEMS Survey

This is the first paper of a series describing our measurement of weak lensing by large-scale structure using archival observations from the Advanced Camera for Surveys (ACS) on board the Hubble Space Telescope (HST). In this work we present results from a pilot study testing the capabilities of the ACS for cosmic shear measurements with early parallel observations and presenting a re-analysis of HST/ACS data from the GEMS survey and the GOODS observations of the Chandra Deep Field South (CDFS). We describe our new correction scheme for the time-dependent ACS PSF based on observations of stellar fields. This is currently the only technique which takes the full time variation of the PSF between individual ACS exposures into account. We estimate that our PSF correction scheme reduces the systematic contribution to the shear correlation functions due to PSF distortions to < 2*10^{-6} for galaxy fields containing at least 10 stars. We perform a number of diagnostic tests indicating that the remaining level of systematics is consistent with zero for the GEMS and GOODS data confirming the success of our PSF correction scheme. For the parallel data we detect a low level of remaining systematics which we interpret to be caused by a lack of sufficient dithering of the data. Combining the shear estimate of the GEMS and GOODS observations using 96 galaxies arcmin^{-2} with the photometric redshift catalogue of the GOODS-MUSIC sample, we determine a local single field estimate for the mass power spectrum normalisation sigma_{8,CDFS}=0.52^{+0.11}_{-0.15} (stat) +/- 0.07 (sys) (68% confidence assuming Gaussian cosmic variance) at fixed Omega_m=0.3 for a LambdaCDM cosmology. We interpret this exceptionally low estimate to be due to a local under-density of the foreground structures in the CDFS.Comment: Version accepted for publication in Astronomy & Astrophysics with 28 pages, 25 figures. A version with full resolution figures can be downloaded from http://www.astro.uni-bonn.de/~schrabba/papers/cosmic_shear_acs1_v2.pd

Risk reclassification analysis investigating the added value of fatigue to sickness absence predictions

Prognostic models including age, self-rated health and prior sickness absence (SA) have been found to predict high (a parts per thousand yen30) SA days and high (a parts per thousand yen3) SA episodes during 1-year follow-up. More predictors of high SA are needed to improve these SA prognostic models. The purpose of this study was to investigate fatigue as new predictor in SA prognostic models by using risk reclassification methods and measures. This was a prospective cohort study with 1-year follow-up of 1,137 office workers. Fatigue was measured at baseline with the 20-item checklist individual strength and added to the existing SA prognostic models. SA days and episodes during 1-year follow-up were retrieved from an occupational health service register. The added value of fatigue was investigated with Net Reclassification Index (NRI) and integrated discrimination improvement (IDI) measures. In total, 579 (51 %) office workers had complete data for analysis. Fatigue was prospectively associated with both high SA days and episodes. The NRI revealed that adding fatigue to the SA days model correctly reclassified workers with high SA days, but incorrectly reclassified workers without high SA days. The IDI indicated no improvement in risk discrimination by the SA days model. Both NRI and IDI showed that the prognostic model predicting high SA episodes did not improve when fatigue was added as predictor variable. In the present study, fatigue increased false-positive rates which may reduce the cost-effectiveness of interventions for preventing SA

Multicentre validation of frequent sickness absence predictions

A prediction model including age, self-rated health (SRH) and prior sickness absence (SA) has previously been found to predict frequent SA.To further validate the model and develop it for clinical use.A multicentre study of care of the elderly workers employed at one of 14 centres in Aarhus (Denmark). SA episodes recorded in the year prior to baseline and both age and SRH at baseline were included in a prediction model for frequent (three or more) SA episodes during a 1-year follow-up period. The prediction model was developed in the largest centre. Risk predictions and discrimination between high- and low-risk workers were investigated in the other centres. The prediction rule 'SRH-prior SA' was derived from the prediction model and prognostic properties of the prediction rule were investigated for each centre, using score &lt;0 as cut-off.Of 2562 workers, 1930 had complete data for analysis. Predictions were accurate in 4 of 13 centres; discrimination was good in five and fair in another five centres. Prediction rule scores &lt;0 identified workers at risk of frequent SA with sensitivities of 0.17-0.54, specificities of 0.86-0.96 and positive predictive values of 0.54-0.87 across centres.The prediction model discriminated between workers at high and low risk of frequent SA in the majority of centres. The prediction rule 'SRH-prior SA' can be used in clinical practice specifically to identify workers at high risk of frequent SA.</p

Cluster Masses Accounting for Structure along the Line of Sight

Weak gravitational lensing of background galaxies by foreground clusters offers an excellent opportunity to measure cluster masses directly without using gas as a probe. One source of noise which seems difficult to avoid is large scale structure along the line of sight. Here I show that, by using standard map-making techniques, one can minimize the deleterious effects of this noise. The resulting uncertainties on cluster masses are significantly smaller than when large scale structure is not properly accounted for, although still larger than if it was absent altogether.Comment: 5 pages, 5 figure

Multifactorial evaluation and treatment of persons with a high risk of recurrent falling was not cost-effective

This study evaluated the cost-effectiveness of multifactorial evaluation and treatment of fall risk factors in community-dwelling older persons at high risk of falling. The intervention and usual care groups did not differ in fall risk or costs. The multifactorial approach was not cost-effective compared to usual care in this group. Introduction: International guidelines recommend multifactorial evaluation and tailored treatment of risk factors to reduce falling in older persons. The cost-effectiveness may be enhanced in high-risk persons. Our study evaluates the cost-effectiveness of multifactorial evaluation and treatment of fall risk factors in community-dwelling older persons at high risk of recurrent falling. Methods: An economic evaluation was conducted alongside a randomised controlled trial. Participants (≥65 years) with a high risk of recurrent falling were randomised into an intervention (n=106) and usual care group (n=111). The intervention consisted of multifactorial assessment and treatment of fall risk factors. Clinical outcomes were proportions of fallers and utility during 1 year. Costs were measured using questionnaires at 3, 6 and 12 months after baseline and valued using cost prices, if available, and guideline prices. Differences in costs and cost-effectiveness were analysed using bootstrapping. Cost-effectiveness planes and acceptability curves were presented. Results: During 1 year, 52% and 56% of intervention and usual care participants reported at least one fall, respectively. The clinical outcome measures did not differ between the two groups. The mean costs were Euro 7,740 (SD 9,129) in the intervention group and Euro 6,838 (SD 8,623) in the usual care group (mean difference Euro 902, bootstrapped 95% CI: -1,534 to 3,357). Cost-effectiveness planes and acceptability curves indicated that multifactorial evaluation and treatment of fall risk factors was not cost-effective compared with usual care. Conclusions: Multifactorial evaluation and treatment of persons with a high risk of recurrent falling was not cost-effective compared to usual care

Framingham score and work-related variables for predicting cardiovascular disease in the working population

Background: The Framingham score is commonly used to estimate the risk of cardiovascular disease (CVD). This study investigated whether work-related variables improve Framingham score predictions of sickness absence due to CVD. Methods: Eleven occupational health survey variables (descent, marital status, education, work type, work pace, cognitive demands, supervisor support, co-worker support, commitment to work, intrinsic work motivation and distress) and the Framingham Point Score (FPS) were combined into a multi-variable logistic regression model for CVD sickness absence during 1-year follow-up of 19 707 survey participants. The Net Reclassification Index (NRI) was used to investigate the added value of work-related variables to the FPS risk classification. Discrimination between participants with and without CVD sickness absence during follow-up was investigated by the area under the receiver operating characteristic curve (AUC). Results: A total of 129 (0.7%) occupational health survey participants had CVD sickness absence during 1-year follow-up. Manual work and high cognitive demands, but not the other work-related variables contributed to the FPS predictions of CVD sickness absence. However, work type and cognitive demands did not improve the FPS classification for risk of CVD sickness absence [NRI = 2.3%; 95% confidence interval (CI) -2.7 to 9.5%; P = 0.629]. The FPS discriminated well between participants with and without CVD sickness absence (AUC = 0.759; 95% CI 0.724-0.794). Conclusion: Work-related variables did not improve predictions of CVD sickness absence by the FPS. The non-laboratory Framingham score can be used to identify health survey participants at risk of CVD sickness absence

Cosmological weak lensing with the HST GEMS survey

We present our cosmic shear analysis of GEMS, one of the largest wide-field surveys ever undertaken by the Hubble Space Telescope. Imaged with the Advanced Camera for Surveys (ACS), GEMS spans 795 square arcmin in the Chandra Deep Field South. We detect weak lensing by large-scale structure in high resolution F606W GEMS data from ~60 resolved galaxies per square arcminute. We measure the two-point shear correlation function, the top-hat shear variance and the shear power spectrum, performing an E/B mode decomposition for each statistic. We show that we are not limited by systematic errors and use our results to place joint constraints on the matter density parameter Omega_m and the amplitude of the matter power spectrum sigma_8. We find sigma_8(Omega_m/0.3)^{0.65}=0.68 +/- 0.13 where the 1sigma error includes both our uncertainty on the median redshift of the survey and sampling variance. Removing image and point spread function (PSF) distortions are crucial to all weak lensing analyses. We therefore include a thorough discussion on the degree of ACS PSF distortion and anisotropy which we characterise directly from GEMS data. Consecutively imaged over 20 days, GEMS data also allows us to investigate PSF instability over time. We find that, even in the relatively short GEMS observing period, the ACS PSF ellipticity varies at the level of a few percent which we account for with a semi-time dependent PSF model. Our correction for the temporal and spatial variability of the PSF is shown to be successful through a series of diagnostic tests.Comment: 17 pages, 16 figures. Version accepted by MNRA

The Current Status of Immune Checkpoint Inhibitors in Neuro-Oncology:A Systematic Review

The introduction of immune checkpoint inhibitors (ICI), as a novel treatment modality, has transformed the field of oncology with unprecedented successes. However, the efficacy of ICI for patients with glioblastoma or brain metastases (BMs) from any tumor type is under debate. Therefore, we systematically reviewed current literature on the use of ICI in patients with glioblastoma and BMs. Prospective and retrospective studies evaluating the efficacy and survival outcomes of ICI in patients with glioblastoma or BMs, and published between 2006 and November 2019, were considered. A total of 88 studies were identified (n = 8 in glioblastoma and n = 80 in BMs). In glioblastoma, median progression-free (PFS) and overall survival (OS) of all studies were 2.1 and 7.3 months, respectively. In patients with BMs, intracranial responses have been reported in studies with melanoma and non-small-cell lung cancer (NSCLC). The median intracranial and total PFS in these studies were 2.7 and 3.0 months, respectively. The median OS in all studies for patients with brain BMs was 8.0 months. To date, ICI demonstrate limited efficacy in patients with glioblastoma or BMs. Future research should focus on increasing the local and systemic immunological responses in these patients

Ultra-deep catalog of X-ray groups in the Extended Chandra Deep Field South

Ultra-deep observations of ECDF-S with Chandra and XMM-Newton enable a search for extended X-ray emission down to an unprecedented flux of $2\times10^{-16}$ ergs s$^{-1}$ cm$^{-2}$. We present the search for the extended emission on spatial scales of 32$^{\prime\prime}$ in both Chandra and XMM data, covering 0.3 square degrees and model the extended emission on scales of arcminutes. We present a catalog of 46 spectroscopically identified groups, reaching a redshift of 1.6. We show that the statistical properties of ECDF-S, such as logN-logS and X-ray luminosity function are broadly consistent with LCDM, with the exception that dn/dz/d$\Omega$ test reveals that a redshift range of $0.2<z<0.5$ in ECDF-S is sparsely populated. The lack of nearby structure, however, makes studies of high-redshift groups particularly easier both in X-rays and lensing, due to a lower level of clustered foreground. We present one and two point statistics of the galaxy groups as well as weak-lensing analysis to show that the detected low-luminosity systems are indeed low-mass systems. We verify the applicability of the scaling relations between the X-ray luminosity and the total mass of the group, derived for the COSMOS survey to lower masses and higher redshifts probed by ECDF-S by means of stacked weak lensing and clustering analysis, constraining any possible departures to be within 30% in mass. Abridged.Comment: 20 pages, 21 figures, 3 tables, to match the journal versio