Five-Year Weight Loss Experience of Outpatients Receiving Laparoscopic Adjustable Gastric Band Surgery

BACKGROUND: This study evaluated the efficacy and safety of laparoscopic adjustable gastric banding (LAGB) in a large cohort of morbidly obese patients followed for up to 5 years. METHODS: Morbidly obese patients, ≥16 years of age, who underwent LAGB surgery at the Surgical Weight Loss Clinic in Ontario, Canada, between May 2005 and January 2011 were eligible for this retrospective chart review. Electronic files were searched to identify all patients who met the inclusion/exclusion criteria. Demographics, weights at baseline and follow-up visits (up to 60 months following surgery), and post-operative complications were documented. As follow-up visits occurred at unevenly spaced intervals within and across patients, modeling methods were used to more accurately assess mean % weight loss (WL) and % excess weight loss (EWL) over time. RESULTS: This study included 2,815 patients (82 % female, mean age 43 years, mean baseline BMI 44.6 kg/m(2)) followed for a mean of 21.8 ± 15.4 months. Complications developed in 238 patients (8.5 %), the most frequent being prolapse/slippage (4.2 %), tubing/access port problems (1.2 %), and explantation (1.2 %). Mean %WL and %EWL progressed continuously over the first 2.5 years post-LAGB, plateauing at 20 and 49 %, respectively, for up to 5 years of follow up. Factors associated with increased weight loss were time since surgery, greater baseline weight (excess weight), older age at time of surgery, and male gender. CONCLUSIONS: Weight loss was maintained for up to 5 years in our population of patients who underwent LAGB for the treatment of morbid obesity

Effect of motor vehicle emissions on respiratory health in an urban area.

Motor vehicles emit particulate matter < 2.5 microm in diameter (PM(2.5)), and as a result, PM(2.5) concentrations tend to be elevated near busy streets. Studies of the relationship between motor vehicle emissions and respiratory health are generally limited by difficulties in exposure assessment. We developed a refined exposure model and implemented it using a geographic information system to estimate the average daily census enumeration area (EA) exposure to PM(2.5). Southeast Toronto, the study area, includes 334 EAs and covers 16 km(2) of urban area. We used hospital admission diagnostic codes from 1990 to 1992 to measure respiratory and genitourinary conditions. We assessed the effect of EA exposure on hospital admissions using a Poisson mixed-effects model and examined the spatial distributions of variables. Exposure to PM(2.5) has a significant effect on admission rates for a subset of respiratory diagnoses (asthma, bronchitis, chronic obstructive pulmonary disease, pneumonia, upper respiratory tract infection), with a relative risk of 1.24 (95% confidence interval, 1.05-1.45) for a log(10) increase in exposure. We noted a weaker effect of exposure on hospitalization for all respiratory conditions, and no effect on hospitalization for nonrespiratory conditions

An encyclopedia of mouse DNA elements (Mouse ENCODE)

To complement the human Encyclopedia of DNA Elements (ENCODE) project and to enable a broad range of mouse genomics efforts, the Mouse ENCODE Consortium is applying the same experimental pipelines developed for human ENCODE to annotate the mouse genome

Development and Evaluation of a Psychosocial Intervention for Children and Teenagers Experiencing Diabetes (DEPICTED): a protocol for a cluster randomised controlled trial of the effectiveness of a communication skills training programme for healthcare professionals working with young people with type 1 diabetes

Background Diabetes is the third most common chronic condition in childhood and poor glycaemic control leads to serious short-term and life-limiting long-term complications. In addition to optimal medical management, it is widely recognised that psychosocial and educational factors play a key role in improving outcomes for young people with diabetes. Recent systematic reviews of psycho-educational interventions recognise the need for new methods to be developed in consultation with key stakeholders including patients, their families and the multidisciplinary diabetes healthcare team. Methods/design Following a development phase involving key stakeholders, a psychosocial intervention for use by paediatric diabetes staff and not requiring input from trained psychologists has been developed, incorporating a communication skills training programme for health professionals and a shared agenda-setting tool. The effectiveness of the intervention will be evaluated in a cluster-randomised controlled trial (RCT). The primary outcome, to be measured in children aged 4-15 years diagnosed with type 1 diabetes for at least one year, is the effect on glycaemic control (HbA1c) during the year after training of the healthcare team is completed. Secondary outcomes include quality of life for patients and carers and cost-effectiveness. Patient and carer preferences for service delivery will also be assessed. Twenty-six paediatric diabetes teams are participating in the trial, recruiting a total of 700 patients for evaluation of outcome measures. Half the participating teams will be randomised to receive the intervention at the beginning of the trial and remaining centres offered the training package at the end of the one year trial period. Discussion The primary aim of the trial is to determine whether a communication skills training intervention for specialist paediatric diabetes teams will improve clinical and psychological outcomes for young people with type 1 diabetes. Previous research indicates the effectiveness of specialist psychological interventions in achieving sustained improvements in glycaemic control. This trial will evaluate an intervention which does not require the involvement of trained psychologists, maximising the potential feasibility of delivery in a wider NHS context. Trial registration Current Controlled Trials ISRCTN61568050

Spatiotemporal DNA methylome dynamics of the developing mouse fetus

Cytosine DNA methylation is essential for mammalian development but understanding of its spatiotemporal distribution in the developing embryo remains limited. Here, as part of the mouse Encyclopedia of DNA Elements (ENCODE) project, we profiled 168 methylomes from 12 mouse tissues or organs at 9 developmental stages from embryogenesis to adulthood. We identified 1,808,810 genomic regions that showed variations in CG methylation by comparing the methylomes of different tissues or organs from different developmental stages. These DNA elements predominantly lose CG methylation during fetal development, whereas the trend is reversed after birth. During late stages of fetal development, non-CG methylation accumulated within the bodies of key developmental transcription factor genes, coinciding with their transcriptional repression. Integration of genome-wide DNA methylation, histone modification and chromatin accessibility data enabled us to predict 461,141 putative developmental tissue-specific enhancers, the human orthologues of which were enriched for disease-associated genetic variants. These spatiotemporal epigenome maps provide a resource for studies of gene regulation during tissue or organ progression, and a starting point for investigating regulatory elements that are involved in human developmental disorders

Association of Type 1 Diabetes vs Type 2 Diabetes Diagnosed During Childhood and Adolescence With Complications During Teenage Years and Young Adulthood

The burden and determinants of complications and comorbidities in contemporary youth-onset diabetes are unknown

The Time It Takes Elderly and Young Individuals to Draw Pictures and Write Words

Twenty elderly and 20 young Ss drew pictures or wrote words for picture or word stimuli. Elderly Ss had slower response initiation than young Ss, especially when drawing. Beyond this, both age groups processed picture and word stimuli similarly. Elderly and young Ss exhibited equivalent latency increases for cross-modality trials (e.g., draw a picture given a word) over within-modality trials (e.g., draw a picture given a picture), regardless of stimulus or task modality. Strong support was found for a mathematical model of these results, which assumes age-related additive slowing for input and output subprocesses but age invariance for a cross-modality transfer subprocess. However, regressing elderly on young whole-condition latencies indicated general, multiplicative slowing: a discrepancy that questions the utility of the global Brinley plot procedure in revealing the nature of age-related slowing

Theoretical Analysis of the Cognitive Processing of Lexical and Pictorial Stimuli: Reading, Naming, and Visual and Conceptual Comparisons

This article reviews the research literature on the differences between word reading and picture naming. A theory for the visual and cognitive processing of pictures and words is then introduced. The theory accounts for slower naming of pictures than reading of words. Reading aloud involves a fast, grapheme-to-phoneme transformation process, whereas picture naming involves two additional processes: (a) determining the meaning of the pictorial stimulus and (b) finding a name for the pictorial stimulus. We conducted a reading-naming experiment, and the time to achieve (a) and (b) was determined to be approximately 160 ms. On the basis of data from a second experiment, we demonstrated that there is no significant difference in time to visually compare two pictures or two words when size of the stimuli is equated. There is no difference in time to make the two types of cross-modality conceptual comparisons (picture first, then word, or word first, then picture). The symmetry of the visual and conceptual comparison results supports the hypothesis that the coding of the mind is neither intrinsically linguistic nor imagistic, but rather it is abstract. There is a potent stimulus size effect, equal for both pictorial and lexical stimuli. Small stimuli take longer to be visually processed than do larger stimuli. For optimal processing, stimuli should not only be equated for size, but should subtend a visual angle of at least 3°. The article ends with the presentation of a mathematical theory that jointly accounts for the data from word-reading, picture-naming visual comparison, and conceptual-comparison experiments

Food deserts in the prairies? supermarket accessibility and neighborhood need in Edmonton, Canada

The U.S. and U.K. literatures have discussed “food deserts,” reflecting populated, typically urban, low-income areas with limited access to full-service supermarkets. Less is known about supermarket accessibility within Canadian cities. This article uses the minimum distance and coverage methods to determine supermarket accessibility within the city of Edmonton, Canada, with a focus on high-need and inner-city neighborhoods. The results show that for 1999 both of these areas generally had higher accessibility than the remainder of the city, but six high-need neighborhoods had poor supermarket accessibility. We conclude by examining potential reasons for differences in supermarket accessibility between Canadian, U.S., and U.K. cities