The Clinical Utility of a Precision Medicine Blood Test Incorporating Age, Sex, and Gene Expression for Evaluating Women with Stable Symptoms Suggestive of Obstructive Coronary Artery Disease: Analysis from the PRESET Registry.

Background: Evaluating women with symptoms suggestive of coronary artery disease (CAD) remains challenging. A blood-based precision medicine test yielding an age/sex/gene expression score (ASGES) has shown clinical validity in the diagnosis of obstructive CAD. We assessed the effect of the ASGES on the management of women with suspected obstructive CAD in a community-based registry. Materials and Methods: The prospective PRESET (A Registry to Evaluate Patterns of Care Associated with the Use of Corus® CAD in Real World Clinical Care Settings) Registry (NCT01677156) enrolled 566 patients presenting with symptoms suggestive of stable obstructive CAD from 21 United States primary care practices from 2012 to 2014. Demographics, clinical characteristics, and referrals to cardiology or further functional and/or anatomical cardiac studies after ASGES testing were collected for this subgroup analysis of women from the PRESET Registry. Patients were followed for 1-year post-ASGES testing. Results: This study cohort included 288 women with a median age 57 years. The median body mass index was 29.2, with hyperlipidemia and hypertension present in 48% and 43% of patients, respectively. Median ASGES was 8.5 (range 1-40), with 218 (76%) patients having low (≤15) ASGES. Clinicians referred 9% (20/218) low ASGES versus 44% (31/70) elevated ASGES women for further cardiac evaluation (odds ratio 0.14, p < 0.0001, adjusted for patient demographics and clinical covariates). Across the score range, higher ASGES were associated with a higher likelihood of posttest cardiac referral. At 1-year follow-up, low ASGES women experienced fewer major adverse cardiac events than elevated ASGES women (1.3% vs. 4.2% respectively, p = 0.16). Conclusions: Incorporation of ASGES into the diagnostic workup demonstrated clinical utility by helping clinicians identify women less likely to benefit from further cardiac evaluation

Goal-directed versus outcome-based financial incentives for weight loss among low-income patients with obesity: rationale and design of the Financial Incentives foR Weight Reduction (FIReWoRk) randomised controlled trial.

IntroductionObesity is a major public health challenge and exacerbates economic disparities through employment discrimination and increased personal health expenditures. Financial incentives for weight management may intensify individuals' utilisation of evidence-based behavioural strategies while addressing obesity-related economic disparities in low-income populations. Trials have focused on testing incentives contingent on achieving weight loss outcomes. However, based on social cognitive and self-determination theories, providing incentives for achieving intermediate behavioural goals may be more sustainable than incentivising outcomes if they enhance an individual's skills and self-efficacy for maintaining long-term weight loss. The objective of this paper is to describe the rationale and design of the Financial Incentives foR Weight Reduction study, a randomised controlled trial to test the comparative effectiveness and cost-effectiveness of two financial incentive strategies for weight loss (goal directed vs outcome based) among low-income adults with obesity, as well as compared with the provision of health behaviour change resources alone.Methods and analysisWe are recruiting 795 adults, aged 18-70 years with a body mass index ≥30 kg/m2, from three primary care clinics serving residents of socioeconomically disadvantaged neighbourhoods in New York City and Los Angeles. All participants receive a 1-year commercial weight loss programme membership, self-monitoring tools (bathroom scale, food journal and Fitbit Alta HR), health education and monthly check-in visits. In addition to these resources, those in the two intervention groups can earn up to $750 over 6 months for: (1) participating in an intensive weight management programme, self-monitoring weight and diet and meeting physical activity guidelines (goal-directed arm); or (2) a ≥1.5% to ≥5% reduction in baseline weight (outcome-based arm). To maximise incentive efficacy, we incorporate concepts from behavioural economics, including immediacy of payments and framing feedback to elicit regret aversion. We will use generalised mixed effect models for repeated measures to examine intervention effects on weight at 6, 9 and 12 months.Ethics and disseminationHuman research protection committees at New York University School of Medicine, University of California Los Angeles (UCLA) David Geffen School of Medicine and Olive-View-UCLA Medical Center granted ethics approval. We will disseminate the results of this research via peer-reviewed publications, conference presentations and meetings with stakeholders.Trial registration numberNCT03157713

The Effect of Music on Body Sway When Standing in a Moving Virtual Environment

poster abstractMovement of the visual surrounding using virtual reality (VR) is an established tool for testing body sway for clinical and research purposes. There are, however, no conclusive studies showing the effects music can have on body sway especially if it is heard in conjunction with a shifting visual surrounding. For this study subjects stood quietly with their eyes closed, with their eyes open, and with their eyes open as they viewed a VR environment translating forward and backward at 0.1 Hz. In addition to these visual conditions, they simultaneously experienced “no sound” and music conditions. The music conditions consisted of their hearing a section of Mozart’s Jupiter and a section of the subjects’ self-selected popular music played normally and also modified so that the loudness and frequency shifted in sync with the VR movement. Body sway was assessed through analysis of center of pressure movement (COP) recorded with force plate, a commonly used device for assessing balance. To date, we have analyzed the body sway of one subject and have found, for that subject, that the addition music enhanced the effect of the translating scene on body sway as measured by increased COP variability, velocity, and a shift in median COP frequency. For this subject, however, it did not appear neither to make a difference whether the subject heard Mozart’s Jupiter or listened to their own self-selected music nor whether the music’s frequency or loudness was synced to the movement of the scene. Should these findings hold with further body sway analysis of more subjects, they would be of interest to clinicians and researchers examining the impact of sound on balance as well as to video game and computer graphics designers looking to create more immersive VR environments

Serum protein electrophoresis under effective control of HIV-1 disease progression

In this report, we compared the serum protein electrophoresis (SPE) patterns in a subset of HIV-1-infected subjects who did not progress to AIDS without antiretroviral treatment with those in whose control of disease progression was achieved by highly active antiretroviral therapy (HAART). SPE and immunofixation electrophoresis were performed on Helena Electrophoresis System according to manufacturer’s instructions. The percentage of SPE abnormalities, resembling chronic inflammation, was significantly higher in HIV-1-infected subject without HAART compared with those under HAART (p = 0.001). The majority of individuals under HAART showed evidence of oligoclonal bands on the γ-band against a polyclonal background compared with those without HAART but β-γ-band bridging was more evident. Immunofixation pattern was consistent with oligoclonal hypergammaglobulinaemia of IgG kappa type, which was found to be more intense in group without HAART. HIV clinical status did not show appreciable effect on the SPE pattern in subjects without HAART. However, under effective HAART, subjects with better CD4 T-cell count were associated with higher γ-globulin band. In group without HAART, acute infection was found to be associated the higher γ-globulin fraction compared with chronic infection. The opposite was the case under effective HAART. HIV infected subjects that did not progress to AIDS were associated with markedly abnormal SPE pattern. Overall results reflect the host ability compensate defective cellular immunity in HIV-1 infection with humoral immune responses. These findings underscore the usefulness of SPE monitoring HIV disease management and identifying individuals that may not progress to full-blown AIDS in the absence of treatment

Jonathan Swift’s Registers in A Modest Proposal

This paper attempts to make a stylistic analysis of Jonathan Swift’s registers in A Modest Proposal.  In literary writing, a writer chooses his words with care, making sure that the words fit properly into the discourse.  This proper choice and use of words is ‘diction’.  In carrying out the subtle task of ensuring proper diction, most writers often search for relevant technical terms appropriate to their discourse with a view to achieving realism.  Thus, a writer becomes a roving camera, delving into other disciplines so as to achieve this realism.  Using the Communication Accommodation Theory (CAT), it is discovered that Swift achieves profound literary realism in A Modest Proposalthrough appropriate diction and navigation in various registers to the extent that one is prone to conclude that Swift’s profession is multi-dimensional in nature, a positive chameleon in terms of his calling; indeed a literary rainbow with several appearances.  Though a single human being, he is discovered to be a man of many diverse parts through his diction that cuts across nine professions/disciplines.  He is a literary writer who delves into various professions simultaneously to have an organic unity which natural novels have in common.  This paper therefore submits that A Modest Proposal is a literary work that exemplifies convergence adjustment aspect of the Communication Accommodating Theory of Howard Giles as a means of effective communication in literary writing. Keywords:Communication Accommodation Theory, Register, Profession, Diction DOI: 10.7176/RHSS/11-16-04 Publication date:August 31st 202

Effective Investigations, A Pivot To Efficient Criminal Justice Administration: Challenges In Nigeria

This paper identifies the connection between effective criminal investigations and the efficiency of criminal justice administration in Nigeria. It further examines the challenges of criminal investigations and concludes with suggestions for improving criminal investigative activities. Eight challenges of criminal investigations were identified and examined. These challenges are: the low crime reporting culture of the public, paucity of police funding, corruption, inadequate training of police officers in criminal investigations, delayed duplication of investigation case files, missing investigation case files, lack of forensic science facilities and experts; and poor public records keeping. The suggestions proffered for improving criminal investigation activities focus on these eight examined challenges and they cut across issues of funding, legislation, policy change, structural reform, personnel training and intervention by non-governmental organisations as well as other stakeholders

Agriculture and eutrophication of freshwaters: a review of control measures

Agriculture contributes a larger percentage of phosphorus (P) to freshwaters eutrophication. Fertilizers and manures applications over a period of time lead to P soil build up exceeding the required needs of the crops. Excess P is transferred into the waters through runoff, erosion, leaching and artificial drainage which impairs water quality, restricts water use for fisheries, promotes harmful algal bloom of Cyanobacteria and Pfiesteria - which pose serious health hazards to livestock and humans. Many measures are taken toward the control of P loss from agricultural soil into the water. Tremendous reductions were achieved in the P loss concentrations from soil to water. However, these control measures could only help in reducing the concentration of particulate phosphorus (PP) which is associated with soil particles. Dissolved phosphorus (DP) still finds its way into the waters. Further efforts must be made toward reducing the P loss from agricultural soil into waters to the minimum levels.Keywords: Eutrophication, Phosphorus, Freshwater, Agricultur

English Language Learning and Development of Teen Poetry in Contemporary Nigeria

It is a known fact that English Language is Nigeria’s official language. As such, it is the language of administration, banking, commerce, education, inter-cultural interaction and a host of other sectors. It is strong in education in that it is the language of teaching and learning at all levels of education, including the secondary school (level) where we have the bulk of teenagers. In most schools in the country, their ability to express themselves in poetic form has developed poetry writing in Nigeria to a level that is fast becoming comparable to that of experienced adult poets. Adopting the conventional literary analysis method, the paper examines several poems in Beyond Limits and discovers that the teen poets in Nigeria have developed appreciably contemporary themes of poverty, environmental degradation, man’s inhumanity to man, patriotism, hopelessness as well as myriad of others which they handle with cheering dexterity. The poems are rich in commendable musicality, impressive symbolisms, appropriate figures of speech as well as good diction. Going by the depth of richness of the themes as well as poetic and linguistic devices, the paper concludes that some contemporary Nigerian teen students have adequately learnt the English Language and have hitherto used it for the development of teenage poetry in contemporary Nigeria. Key words: Language Teaching and Learning, Poetry, Teenager

Utilization of vast Nigeria’s bamboo resources for economic growth: a review

Bamboo is recognized as an industrial raw material globally and has tremendous potentials for the economic development of the nations. This paper reviewed the potentials of the abundant Nigeria’s bamboo resources used for house construction, household items, biofuel, charcoal, pulp and paper, irrigation and drainage pipes, textiles materials, chemical and pharmaceutical products. It also reviewed the challenges facing the development of the bamboo industries. The policy makers lack the general understanding of the industrial potentials of bamboo. Despite the vast bamboo resources and species in the nation, the Nigerian government has not fully recognized the importance of bamboo and its role as a substitute to wood in major applications and how it can boost the economy. Recommendations highlighted for the harnessing of the resources included National Bamboo Policy and Nigerian Bamboo Producers development. A bamboo inventory of quantity, quality, species and distribution across the nation must be provided. Government should also promote of bamboo tenure system and incentives to encourage its cultivation among local farmers.Keywords: Bamboo, resources, industries, economic developmen