Moderate exercise increases affinity of large very low density lipoproteins for hydrolysis by lipoprotein lipase

Context: Postprandial triglyceride (TG) concentration is independently associated with cardiovascular disease risk. Exercise reduces postprandial TG concentrations but the mechanisms responsible are unclear. Objective: To determine the effects of exercise on affinity of chylomicrons, large very low density lipoproteins (VLDL1) and smaller VLDL (VLDL2) for lipoprotein lipase (LPL) mediated TG hydrolysis. Design: Within-participant cross-over study. Setting: A University metabolic investigation unit. Participants: Ten overweight/obese men. Interventions: Participants undertook two oral fat tolerance tests, separated by 7–14 days, in which they had blood taken fasting and for 4 hours after a high-fat mixed meal. On the afternoon before one test, they performed a 90-minute treadmill walk at 50% maximal oxygen uptake (EX); no exercise was performed before the control test (CON). Main outcome measures: Circulating TG-rich lipoprotein concentrations; affinity of chylomicrons, VLDL1, VLDL2 for LPL-mediated TG hydrolysis. Results: Exercise significantly reduced fasting VLDL1-TG concentration (CON: 0.49(0.33–0.72) mmol.l−1, EX: 0.36(0.22–0.59) mmol.l−1, [geometric means (95% confidence interval)]; p=0.04). Time-averaged postprandial chylomicron-TG (CON: 0.55±0.10 mmol.l−1, EX: 0.39±0.08 mmol.l−1, [mean±SEM], p=0.03) and VLDL1-TG (CON: 0.85±0.13 mmol.l−1, EX: 0.66±0.10 mmol.l−1, p=0.01) concentrations were both lower in EX than CON. Affinity of VLDL1 for LPL-mediated TG hydrolysis increased by 2.2(1.3–3.7) fold (geometric mean (95% confidence interval)) (p=0.02) in the fasted state and 2.6(1.8–2.6) fold (p=0.001) postprandially. Affinity of chylomicrons and VLDL2 was not significantly different between trials. Conclusions: Exercise increases affinity of VLDL1 for LPL-mediated TG hydrolysis both fasting and postprandially. This mechanism is likely to contribute to exercise's TG-lowering effect

Cost-effectiveness of eplerenone in patients with systolic heart failure and mild symptoms

Aim In the Eplerenone in Mild Patients Hospitalization and Survival Study in Heart Failure (EMPHASIS-HF), aldosterone blockade with eplerenone decreased mortality and hospitalisation in patients with mild symptoms (New York Heart Association class II) and chronic systolic heart failure (HF). The present study evaluated the cost-effectiveness of eplerenone in the treatment of these patients in the UK and Spain.<p></p> Methods and results Results from the EMPHASIS-HF trial were used to develop a discrete-event simulation model estimating lifetime direct costs and effects (life years and quality-adjusted life years (QALYs) gained) of the addition of eplerenone to standard care among patients with chronic systolic HF and mild symptoms. Eplerenone plus standard care compared with standard care alone increased lifetime direct costs per patient by £4284 for the UK and €7358 for Spain, with additional quality-adjusted life expectancy of 1.22 QALYs for the UK and 1.33 QALYs for Spain. Mean lifetime costs were £3520 per QALY in the UK and €5532 per QALY in Spain. Probabilistic sensitivity analysis suggested a 100% likelihood of eplerenone being regarded as cost-effective at a willingness-to-pay threshold of £20 000 per QALY (UK) or €30 000 per QALY (Spain).<p></p> Conclusions By currently accepted standards of value for money, the addition of eplerenone to optimal medical therapy for patients with chronic systolic HF and mild symptoms is likely to be cost-effective.<p></p&gt

Constraining the Kahler Moduli in the Heterotic Standard Model

Phenomenological implications of the volume of the Calabi-Yau threefolds on the hidden and observable M-theory boundaries, together with slope stability of their corresponding vector bundles, constrain the set of Kaehler moduli which give rise to realistic compactifications of the strongly coupled heterotic string. When vector bundles are constructed using extensions, we provide simple rules to determine lower and upper bounds to the region of the Kaehler moduli space where such compactifications can exist. We show how small these regions can be, working out in full detail the case of the recently proposed Heterotic Standard Model. More explicitely, we exhibit Kaehler classes in these regions for which the visible vector bundle is stable. On the other hand, there is no polarization for which the hidden bundle is stable.Comment: 28 pages, harvmac. Exposition improved, references and one figure added, minor correction

(1+1)-dimensional Baryons from the SU(N) Color-Flavor Transformation

The color-flavor transformation, an identity that connects two integrals, each of which is over one of a dual pair of Lie groups acting in the fermionic Fock space, is extended to the case of the special unitary group. Using this extension, a toy model of lattice QCD is studied: N_f species of spinless fermions interacting with strongly coupled SU(N_c) lattice gauge fields in 1+1 dimensions. The color-flavor transformed theory is expressed in terms of gauge singlets, the meson fields, organized into sectors distinguished by the distribution of baryonic flux. A comprehensive analytical and numerical search is made for saddle-point configurations of the meson fields, with various topological charges, in the vacuum and single-baryon sectors. Two definitions of the static baryon on the square lattice, straight and zigzag, are investigated. The masses of the baryonic states are estimated using the saddle-point approximation for large N_c.Comment: LateX, 53 pages, 13 figure

Ground state non-universality in the random field Ising model

Two attractive and often used ideas, namely universality and the concept of a zero temperature fixed point, are violated in the infinite-range random-field Ising model. In the ground state we show that the exponents can depend continuously on the disorder and so are non-universal. However, we also show that at finite temperature the thermal order parameter exponent one half is restored so that temperature is a relevant variable. The broader implications of these results are discussed.Comment: 4 pages 2 figures, corrected prefactors caused by a missing factor of two in Eq. 2., added a paragraph in conclusions for clarit

The role of preoperative iron deficiency in colorectal cancer patients: prevalence and treatment

Background: In preoperative blood management of colorectal cancer patients, intravenous iron therapy is increasingly used to treat anaemia and prevent red blood cell transfusions. However, while iron deficiency is the most common cause of anaemia, little is known about the prevalence and namely type of iron deficiency in this population, whereas both types of iron deficiency (i.e. absolute and functional iron deficiency) are recommended to be treated differently by international cancer guidelines. Objective: The aim of present study is to investigate the prevalence and namely type of iron deficiency in colorectal cancer patients, and to assess its clinical relevance. Methods: Preoperative iron status, clinical parameters (i.e. age, ASA classification, tumour location, tumour stage) and postoperative complications were retrospectively collected for all newly diagnosed colorectal cancer patients in our institution over a 3-year period. Results: Iron deficiency was observed in 163 (48.1%) of 339 patients. Of these iron-deficient patients, 3.7% had an isolated absolute iron deficiency (AID) and 15.3% a functional iron deficiency (FID), while the rest had a combination of AID and FID. Anaemia was present in 66.1% of iron-deficient patients. Iron deficiency was significantly associated with an increased postoperative complication rate (univariable OR 1.94, p = 0.03, multivariable OR 1.84, p = 0.07), with right-sided tumours (p < 0.001), high ASA classification (p = 0.002), advanced tumour stage (p = 0.01) and advanced age (p = 0.04). In comparing clinical parameters between patients with AID and FID, advanced age was significantly associated with FID (p = 0.03), and the presence of anaemia with AID (p = 0.02). Conclusion: In preoperative colorectal cancer patients, there is a high prevalence of iron deficiency, including a high percentage of patients with—a component of—functional iron deficiency, associated with the increased postoperative complication rate. As both types of iron deficiency require a different treatment strategy, our results illustrate the therapeutic potential of especially intravenous iron supplementation in patients with severe iron deficiency and stress the urgency of routinely monitoring preoperative iron status and differentiation between types of iron deficiency. As iron therapy may also be potentially harmful in respect to stimulation of tumour growth, future clinical trials assessing the long-term effect of iron therapy are necessary

Beyond locutionary denotations: exploring trust between practitioners and policy

This study reports the findings of a research on the trust relationship between practitioners in the Skills for Life (SfL) area and the policy that informs their practice. The exploration of this relationship was premised on an extended notion of trust relationship which draws from the Speech Act theory of Austin (1962; Searle 1969; Kissine 2008), leading to the claim that the existence of different layers of imports in textual analysis makes it possible for a trust relationship to exist between the human/physical and the non human/non physical. The study found that the majority of practitioners in the SfL field trust policy to deliver its inherent policy only to a limited extent. Amongst others, the study identified the impact of the perlocutionary import of policy text on practitioners as a viable reason for this limited level of trust. Such perlocutionary imports, it also found, have adverse impact on practitioners who are considered to have drawn from previous experience to mediate the import of contemporary policies

Spectral Duality Between Heisenberg Chain and Gaudin Model

In our recent paper we described relationships between integrable systems inspired by the AGT conjecture. On the gauge theory side an integrable spin chain naturally emerges while on the conformal field theory side one obtains some special reduced Gaudin model. Two types of integrable systems were shown to be related by the spectral duality. In this paper we extend the spectral duality to the case of higher spin chains. It is proved that the N-site GL(k) Heisenberg chain is dual to the special reduced k+2-points gl(N) Gaudin model. Moreover, we construct an explicit Poisson map between the models at the classical level by performing the Dirac reduction procedure and applying the AHH duality transformation.Comment: 36 page

Dietary studies in birds: testing a non-invasive method using digital photography in seabirds

This is the author accepted manuscript. The final version is available from the publisher via the DOI in this record.Dietary studies give vital insights into foraging behaviour, with implications for understanding changing environmental conditions and the anthropogenic impacts on natural resources. Traditional diet sampling methods may be invasive or subject to biases, so developing non-invasive and unbiased methods applicable to a diversity of species is essential. We used digital photography to investigate the diet fed to chicks of a prey-carrying seabird and compared our approach (photo-sampling) to a traditional method (regurgitations) for the greater crested tern Thalasseus bergii. Over three breeding seasons, we identified >24 000 prey items of at least 48 different species, more than doubling the known diversity of prey taken by this population of terns. We present a method to estimate the length of the main prey species (anchovy Engraulis encrasicolus) from photographs, with an accuracy <1 mm and precision ~ 0·5 mm. Compared to regurgitations at two colonies, photo-sampling produced similar estimates of prey composition and size, at a faster species accumulation rate. The prey compositions collected by two researchers photo-sampling concurrently were also similar. Photo-sampling offers a non-invasive tool to accurately and efficiently investigate the diet composition and prey size of prey-carrying birds. It reduces biases associated with observer-based studies and is simple to use. This methodology provides a novel tool to aid conservation and management decision-making in the light of the growing need to assess environmental and anthropogenic change in natural ecosystems.Department of Science and Technology, South Afric