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Liver transplant recipients’ experiences and perspectives of a telehealth-delivered lifestyle programme A qualitative study

Introduction Dietary modification and exercise are encouraged to address cardiometabolic risk factors after solid organ transplantation. However, the lived experience of attempting positive lifestyle changes for liver transplant recipients is not known. The aim of this study was to explore the experiences of liver transplant recipients and their perspectives of a 12-week telehealth lifestyle programme and assess the feasibility of this innovative health service. Methods Focus groups and one-on-one interviews were conducted with participants who had completed a 12-week, group-based, telehealth-delivered diet and exercise programme and thematic qualitative analysis was used to code and theme the data. Results In total, 19 liver transplant recipients participated in the study (25-68 years, median time since transplant 4.4 years, 63% male). Overarching themes included: (a) 'broad telehealth advantages' which highlighted that telehealth reduced the perceived burdens of face-to-face care; (b) 'impact of employment' which identified employment as a competing priority and appeared to effect involvement with the programme; (c) 'adapting Mediterranean eating pattern to meet individual needs' which identified the adaptability of the Mediterranean diet supported by sessions with the dietitian; (d) 'increasing exercise confidence' which recognised that a tailored approach facilitated confidence and acceptability of the exercise component of the programme. Discussion A telehealth lifestyle programme delivered by dietitians and exercise physiologists is an acceptable alternative to face-to-face care that can meet the needs of liver transplant recipients. There is a need to further innovate and broaden the scope of routine service delivery beyond face-to-face consultations

Disruption of female reproductive function by endotoxins

Endotoxemia can be caused by obesity, environmental chemical exposure, abiotic stressors, and bacterial infection. Circumstances that deleteriously impact intestinal barrier integrity can induce endotoxemia and controlled experiments have identified negative impacts of lipopolysaccharide (LPS; an endotoxin mimetic) on folliculogenesis, puberty onset, estrus behavior, ovulation, meiotic competence, luteal function and ovarian steroidogenesis. In addition, neonatal LPS exposures have transgenerational female reproductive impacts, raising concern about early life contacts to this endogenous reproductive toxicant. Aims of this review are to identify physiological stressors causing endotoxemia, to highlight potential mechanism(s) by which LPS compromises female reproduction, and identify knowledge gaps regarding how acute and/or metabolic endotoxemia influence(s) female reproduction

Negative moments of characteristic polynomials of random GOE matrices and singularity-dominated strong fluctuations

We calculate the negative integer moments of the (regularized) characteristic polynomials of N x N random matrices taken from the Gaussian Orthogonal Ensemble (GOE) in the limit as $N \to \infty$. The results agree nontrivially with a recent conjecture of Berry & Keating motivated by techniques developed in the theory of singularity-dominated strong fluctuations. This is the first example where nontrivial predictions obtained using these techniques have been proved.Comment: 13 page

Spectral statistics for unitary transfer matrices of binary graphs

Quantum graphs have recently been introduced as model systems to study the spectral statistics of linear wave problems with chaotic classical limits. It is proposed here to generalise this approach by considering arbitrary, directed graphs with unitary transfer matrices. An exponentially increasing contribution to the form factor is identified when performing a diagonal summation over periodic orbit degeneracy classes. A special class of graphs, so-called binary graphs, is studied in more detail. For these, the conditions for periodic orbit pairs to be correlated (including correlations due to the unitarity of the transfer matrix) can be given explicitly. Using combinatorial techniques it is possible to perform the summation over correlated periodic orbit pair contributions to the form factor for some low--dimensional cases. Gradual convergence towards random matrix results is observed when increasing the number of vertices of the binary graphs.Comment: 18 pages, 8 figure

COMPASS: a 2.6m telescope for CMBR polarization studies

COMPASS (COsmic Microwave Polarization at Small Scale) is an experiment devoted to measuring the polarization of the CMBR. Its design and characteristics are presented

How much do disasters cost? A comparison of disaster cost estimates in Australia

Extreme weather events in Australia are common and a large proportion of the population are exposed to such events. Therefore, there is great interest as to how these events impact Australia's society and economy, which requires understanding the current and historical impact of disasters. Despite global efforts to record and cost disaster impacts, no standardised method of collecting and recording data retrospectively yet exists. The lack of standardisation in turn results in a range of different estimates of economic impacts. This paper examines five examples of aggregate disaster loss and impacts of natural disasters in Australia, and comparisons between them reveal significant data shortcomings. The reliability of data sources, and the methodology employed to analyse them can have significant impacts on conclusions regarding the overall cost of disasters, the relative costs of different hazards (disaster types), and the distribution of losses across Australian states. We highlight difficulties with time series comparisons, further complicated by the interdependencies of the databases. We reiterate the need for consistent and comparable data collection and analysis, to respond to the increasing frequency and severity of disasters in Australia

Applications and generalizations of Fisher-Hartwig asymptotics

Fisher-Hartwig asymptotics refers to the large $n$ form of a class of Toeplitz determinants with singular generating functions. This class of Toeplitz determinants occurs in the study of the spin-spin correlations for the two-dimensional Ising model, and the ground state density matrix of the impenetrable Bose gas, amongst other problems in mathematical physics. We give a new application of the original Fisher-Hartwig formula to the asymptotic decay of the Ising correlations above $T_c$, while the study of the Bose gas density matrix leads us to generalize the Fisher-Hartwig formula to the asymptotic form of random matrix averages over the classical groups and the Gaussian and Laguerre unitary matrix ensembles. Another viewpoint of our generalizations is that they extend to Hankel determinants the Fisher-Hartwig asymptotic form known for Toeplitz determinants.Comment: 25 page

Prostate Cancer Survivorship: Prevention and Treatment of the Adverse Effects of Androgen Deprivation Therapy

BACKGROUND: More than one-third of the estimated 2 million prostate cancer survivors in the United States receive androgen deprivation therapy (ADT). This population of mostly older men is medically vulnerable to a variety of treatment-associated adverse effects. MEASUREMENTS AND RESULTS: Androgen-deprivation therapy (ADT) causes loss of libido, vasomotor flushing, anemia, and fatigue. More recently, ADT has been shown to accelerate bone loss, increase fat mass, increase cholesterol and triglycerides, and decrease insulin sensitivity. Consistent with these adverse metabolic effects, ADT has also recently been associated with greater risks for fractures, diabetes and cardiovascular disease. CONCLUSION: Primary care clinicians and patients should be aware of the potential benefits and harms of ADT. Screening and intervention to prevent treatment-related morbidity should be incorporated into the routine care of prostate cancer survivors. Evidence-based guidelines to prevent fractures, diabetes, and cardiovascular disease in prostate cancer survivors represent an important unmet need. We recommend the adapted use of established practice guidelines designed for the general population

Random matrix theory, the exceptional Lie groups, and L-functions

There has recently been interest in relating properties of matrices drawn at random from the classical compact groups to statistical characteristics of number-theoretical L-functions. One example is the relationship conjectured to hold between the value distributions of the characteristic polynomials of such matrices and value distributions within families of L-functions. These connections are here extended to non-classical groups. We focus on an explicit example: the exceptional Lie group G_2. The value distributions for characteristic polynomials associated with the 7- and 14-dimensional representations of G_2, defined with respect to the uniform invariant (Haar) measure, are calculated using two of the Macdonald constant term identities. A one parameter family of L-functions over a finite field is described whose value distribution in the limit as the size of the finite field grows is related to that of the characteristic polynomials associated with the 7-dimensional representation of G_2. The random matrix calculations extend to all exceptional Lie groupsComment: 14 page