8,443 research outputs found
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FDG-PET/CT in the diagnosis of aortitis in fever of unknown origin with severe aortic incompetence
Quantifcation of Physical Loading, Energy Intake and Expenditure In English Premier League Soccer Players
The physical demands of soccer match play have been extensively studied. Muscle glycogen is the major energy source required to meet these demands and strategies to maximise this provide clear performance benefits to match play. Such information has allowed sports nutritionists to develop specific guidelines to optimise physical performance and recovery. However, the physical demands of soccer training have only recently started to be examined. For this reason, Study 1 quantified training load in English Premier League soccer players (n=12) during one, two and three game weekly micro-cycles of the 2013-2014 season. Study 1 identified soccer training being significantly less than match play and identified that soccer training displayed evidence of training periodisation. Having identified typical training load during the weekly micro-cycle, it was recognised that soccer match play comprises a large portion of the weekly physical load. Accordingly, Study 2 quantified differences in season long physical load (inclusive of both training and match play) between players who were classified as starters (n=8, started ≥60% of games), fringe players (n=7, started 30-60% of games) and non-starters (n=4, started <30% of games). Study 2 identified that unlike total seasonal volume of training (i.e. total distance and duration), seasonal high-intensity loading patterns are dependent on players’ match starting status thereby having potential implications for training programme design and prescription of player-specific nutritional guidelines. Additionally, daily energy expenditures (EE) and energy intakes (EI) of elite players are also not currently known. Therefore, studies 3, 4 and 5 quantified EE and EI in English Premier League soccer players consisting of outfield positions (n=6), a professional GK (n=1) and a player undergoing a rehabilitation period from an ACL reconstruction (n=1), respectively. Studies 3 and 4 were conducted over a 7-day period of the 2015-2016 season, consisting of two match days (MD) and five training days (TD). Study 5 consisted of six training days and one day off. Studies 3 and 4 identified CHO periodisation strategies employed by English Premier League Players such that CHO intake was greater on MD than TD. Additionally, players readily achieve current guidelines for daily protein and fat intakes, although energy and macronutrient intakes are skewed on TD. Study 4 also identified that the GK exceeded average daily EE with EI although he failed to meet current recommendations for meals on MD. In study 5 the player was operating in an energy deficit and he was able to decrease his total body mass in the initial 1-6 weeks post injury, which was attributable to largely fat loss. In summary, the work undertaken in this thesis has quantified the typical physical loading patterns of professional soccer players according to fixture schedule, starting status and in special populations. Additionally, the quantification of EI and EE (using DLW) also provides the first report of EE in elite soccer players from the English Premier League. When taken together, these data therefore provide a theoretical framework for soccer-specific nutritional guidelines especially in relation to the concept of nutritional (specifically, carbohydrate) periodisation. Further studies are now required to quantify the specific energy and CHO cost of habitual training sessions completed by elite soccer players as well as examining the manipulation of CHO availability on soccer-specific training adaptations
Genome Sequences of Poaceae-Associated Gemycirularviruses from the Pacific Ocean Island of Tonga
We sampled and analyzed 43 Poaceae plants from the Pacific Ocean island of Tonga for the presence of circular DNA viruses.
From these samples, we recovered three gemycircularvirus genomes, which share >99% identity, from Brachiaria deflexa (n
2) and sugarcane (n 1). These genomes share<61% genome-wide identity with other gemycircularvirus sequences in public
databases
Twist Deformations of the Supersymmetric Quantum Mechanics
The N-extended Supersymmetric Quantum Mechanics is deformed via an abelian
twist which preserves the super-Hopf algebra structure of its Universal
Enveloping Superalgebra. Two constructions are possible. For even N one can
identify the 1D N-extended superalgebra with the fermionic Heisenberg algebra.
Alternatively, supersymmetry generators can be realized as operators belonging
to the Universal Enveloping Superalgebra of one bosonic and several fermionic
oscillators. The deformed system is described in terms of twisted operators
satisfying twist-deformed (anti)commutators. The main differences between an
abelian twist defined in terms of fermionic operators and an abelian twist
defined in terms of bosonic operators are discussed.Comment: 18 pages; two references adde
Exercise-based cardiac rehabilitation for coronary heart disease
PublishedReviewThis review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 2016, Issue 1. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review.Background Coronary heart disease (CHD) is the single most common cause of death globally. However, with falling CHD mortality rates, an increasing number of people live with CHD and may need support to manage their symptoms and prognosis. Exercise-based cardiac rehabilitation (CR) aims to improve the health and outcomes of people with CHD. This is an update of a Cochrane systematic review previously published in 2011. Objectives To assess the effectiveness and cost-effectiveness of exercise-based CR (exercise training alone or in combination with psychosocial or educational interventions) compared with usual care on mortality, morbidity and HRQL in patients with CHD. To explore the potential study level predictors of the effectiveness of exercise-based CR in patients with CHD. Search methods We updated searches from the previous Cochrane review, by searching Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 6, 2014) from December 2009 to July 2014. We also searched MEDLINE (Ovid), EMBASE (Ovid), CINAHL (EBSCO) and Science Citation Index Expanded (December 2009 to July 2014). Selection criteria We included randomised controlled trials (RCTs) of exercise-based interventions with at least six months’ follow-up, compared with a no exercise control. The study population comprised men and women of all ages who have had a myocardial infarction (MI), coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI), or who have angina pectoris, or coronary artery disease. We included RCTs that reported at least one of the following outcomes: mortality, MI, revascularisations, hospitalisations, health-related quality of life (HRQL), or costs. Data collection and analysis Two review authors independently screened all identified references for inclusion based on the above inclusion and exclusion criteria. One author extracted data from the included trials and assessed their risk of bias; a second review author checked data. We stratified meta-analysis by the duration of follow up of trials, i.e. short-term: 6 to 12 months, medium-term: 13 to 36 months, and long-term: > 3 years. Main results This review included 63 trials which randomised 14,486 people with CHD. This latest update identified 16 new trials (3872 participants). The population included predominantly post-MI and post-revascularisation patients and the mean age of patients within the trials ranged from 47.5 to 71.0 years.Women accounted for fewer than 15% of the patients recruited. Overall trial reporting was poor, although there was evidence of an improvement in quality of reporting in more recent trials. As we found no significant difference in the impact of exercise-based CR on clinical outcomes across follow-up, we focused on reporting findings pooled across all trials at their longest follow-up (median 12 months). Exercise-based CR reduced cardiovascular mortality compared with no exercise control (27 trials; risk ratio (RR) 0.74, 95% CI 0.64 to 0.86). There was no reduction in total mortality with CR (47 trials, RR 0.96, 95% CI 0.88 to 1.04). The overall risk of hospital admissions was reduced with CR (15 trials; RR 0.82, 95% CI 0.70 to 0.96) but there was no significant impact on the risk of MI (36 trials; RR 0.90, 95% CI 0.79 to 1.04), CABG (29 trials; RR 0.96, 95% CI 0.80 to 1.16) or PCI (18 trials; RR 0.85, 95% CI 0.70 to 1.04). There was little evidence of statistical heterogeneity across trials for all event outcomes, and there was evidence of small study bias for MI and hospitalisation, but no other outcome. Predictors of clinical outcomes were examined across the longest follow-up of studies using univariate meta-regression. Results show that benefits in outcomes were independent of participants’ CHD case mix (proportion of patients with MI), type of CR (exercise only vs comprehensive rehabilitation) dose of exercise, length of follow-up, trial publication date, setting (centre vs home-based), study location (continent), sample size or risk of bias. Given the heterogeneity in outcome measures and reporting methods, meta-analysis was not undertaken for HRQL. In five out of 20 trials reporting HRQL using validated measures, there was evidence of significant improvement in most or all of the sub-scales with exercise-based CR compared to control at follow-up. Four trial-based economic evaluation studies indicated exercise-based CR to be a potentially cost-effective use of resources in terms of gain in quality-adjusted life years. The quality of the evidence for outcomes reported in the review was rated using the GRADE method. The quality of the evidence varied widely by outcome and ranged from low to moderate. Authors’ conclusions This updated Cochrane review supports the conclusions of the previous version of this review that, compared with no exercise control, exercise-based CR reduces the risk of cardiovascular mortality but not total mortality. We saw a significant reduction in the risk of hospitalisation with CR but not in the risk of MI or revascularisation. We identified further evidence supporting improved HRQL with exercise-based CR. More recent trials were more likely to be well reported and include older and female patients. However, the population studied in this review still consists predominantly of lower risk individuals following MI or revascularisation. Further well conducted RCTs are needed to assess the impact of exercise-based CR in higher risk CHD groups and also those presenting with stable angina. These trials should include validated HRQL outcome measures, explicitly report clinical event outcomes including mortality and hospital admissions, and assess costs and cost-effectiveness
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Updates in heart failure.
This review provides a contemporary overview of HF management and highlights the key studies which have informed recent European HF guidelines
How early can myocardial iron overload occur in Beta thalassemia major?
BACKGROUND: Myocardial siderosis is the most common cause of death in patients with beta thalassemia major(TM). This study aimed at investigating the occurrence, prevalence and severity of cardiac iron overload in a young Chinese population with beta TM.
METHODS AND RESULTS: We analyzed T2* cardiac magnetic resonance (CMR), left ventricular ejection fraction (LVEF) and serum ferritin (SF) in 201 beta TM patients. The median age was 9 years old. Patients received an average of 13 units of blood per year. The median SF level was 4536 ng/ml and 165 patients (82.1%) had SF>2500 ng/ml. Myocardial iron overload was detected in 68 patients (33.8%) and severe myocardial iron overload was detected in 26 patients (12.6%). Twenty-two patients ≤10 years old had myocardial iron overload, three of whom were only 6 years old. No myocardial iron overload was detected under the age of 6 years. Median LVEF was 64% (measured by CMR in 175 patients). Five of 6 patients with a LVEF<56% and 8 of 10 patients with cardiac disease had myocardial iron overload.
CONCLUSIONS: The TM patients under follow-up at this regional centre in China patients are younger than other reported cohorts, more poorly-chelated, and have a high burden of iron overload. Myocardial siderosis occurred in patients younger than previously reported, and was strongly associated with impaired LVEF and cardiac disease. For such poorly-chelated TM patients, our data shows that the first assessment of cardiac T2* should be performed as early as 6 years old
The radiation of cynodonts and the ground plan of mammalian morphological diversity
Cynodont therapsids diversified extensively after the Permo-Triassic mass extinction event, and gave rise to mammals in the Jurassic. We use an enlarged and revised dataset of discrete skeletal characters to build a new phylogeny for all main cynodont clades from the Late Permian to the Early Jurassic, and we analyse models of morphological diversification in the group. Basal taxa and epicynodonts are paraphyletic relative to eucynodonts, and the latter are divided into cynognathians and probainognathians, with tritylodonts and mammals forming sister groups. Disparity analyses reveal a heterogeneous distribution of cynodonts in a morphospace derived from cladistic characters. Pairwise morphological distances are weakly correlated with phylogenetic distances. Comparisons of disparity by groups and through time are non-significant, especially after the data are rarefied. A disparity peak occurs in the Early/Middle Triassic, after which period the mean disparity fluctuates little. Cynognathians were characterized by high evolutionary rates and high diversity early in their history, whereas probainognathian rates were low. Community structure may have been instrumental in imposing different rates on the two clades
Deferasirox (Exjade®) significantly improves cardiac T2* in heavily iron-overloaded patients with β-thalassemia major
Noninvasive measurement of tissue iron levels can be assessed using T2* magnetic resonance imaging (MRI) to identify and monitor patients with iron overload. This study monitored cardiac siderosis using T2* MRI in a cohort of 19 heavily iron-overloaded patients with β-thalassemia major receiving iron chelation therapy with deferasirox over an 18-month period. Overall, deferasirox therapy significantly improved mean ± standard deviation cardiac T2* from a baseline of 17.2 ± 10.8 to 21.5 ± 12.8 ms (+25.0%; P = 0.02). A concomitant reduction in median serum ferritin from a baseline of 5,497 to 4,235 ng/mL (−23.0%; P = 0.001), and mean liver iron concentration from 24.2 ± 9.0 to 17.6 ± 12.9 mg Fe/g dry weight (−27.1%; P = 0.01) was also seen. Improvements were seen in patients with various degrees of cardiac siderosis, including those patients with a baseline cardiac T2* of <10 ms, indicative of high cardiac iron burden. These findings therefore support previous observations that deferasirox is effective in the removal of myocardial iron with concomitant reduction in total body iron
Non-supersymmetric heterotic model building
We investigate orbifold and smooth Calabi-Yau compactifications of the
non-supersymmetric heterotic SO(16)xSO(16) string. We focus on such Calabi-Yau
backgrounds in order to recycle commonly employed techniques, like index
theorems and cohomology theory, to determine both the fermionic and bosonic 4D
spectra. We argue that the N=0 theory never leads to tachyons on smooth
Calabi-Yaus in the large volume approximation. As twisted tachyons may arise on
certain singular orbifolds, we conjecture that such tachyonic states are lifted
in the full blow-up. We perform model searches on selected orbifold geometries.
In particular, we construct an explicit example of a Standard Model-like theory
with three generations and a single Higgs field.Comment: 1+30 pages latex, 11 tables; v2: references and minor revisions
added, matches version published in JHE
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