Association of Accelerometry-Measured Physical Activity and Cardiovascular Events in Mobility-Limited Older Adults: The LIFE (Lifestyle Interventions and Independence for Elders) Study.

BACKGROUND:Data are sparse regarding the value of physical activity (PA) surveillance among older adults-particularly among those with mobility limitations. The objective of this study was to examine longitudinal associations between objectively measured daily PA and the incidence of cardiovascular events among older adults in the LIFE (Lifestyle Interventions and Independence for Elders) study. METHODS AND RESULTS:Cardiovascular events were adjudicated based on medical records review, and cardiovascular risk factors were controlled for in the analysis. Home-based activity data were collected by hip-worn accelerometers at baseline and at 6, 12, and 24 months postrandomization to either a physical activity or health education intervention. LIFE study participants (n=1590; age 78.9±5.2 [SD] years; 67.2% women) at baseline had an 11% lower incidence of experiencing a subsequent cardiovascular event per 500 steps taken per day based on activity data (hazard ratio, 0.89; 95% confidence interval, 0.84-0.96; P=0.001). At baseline, every 30 minutes spent performing activities ≥500 counts per minute (hazard ratio, 0.75; confidence interval, 0.65-0.89 [P=0.001]) were also associated with a lower incidence of cardiovascular events. Throughout follow-up (6, 12, and 24 months), both the number of steps per day (per 500 steps; hazard ratio, 0.90, confidence interval, 0.85-0.96 [P=0.001]) and duration of activity ≥500 counts per minute (per 30 minutes; hazard ratio, 0.76; confidence interval, 0.63-0.90 [P=0.002]) were significantly associated with lower cardiovascular event rates. CONCLUSIONS:Objective measurements of physical activity via accelerometry were associated with cardiovascular events among older adults with limited mobility (summary score >10 on the Short Physical Performance Battery) both using baseline and longitudinal data. CLINICAL TRIAL REGISTRATION:URL: http://www.clinicaltrials.gov. Unique identifier: NCT01072500

Explaining Models: Theoretical and Phenomenological Models and Their Role for the First Explanation of the Hydrogen Spectrum

Wilholt T. Explaining Models: Theoretical and Phenomenological Models and Their Role for the First Explanation of the Hydrogen Spectrum. Foundations of Chemistry. 2005;7(2):149-169.Traditional nomological accounts of scientific explanation have assumed that a good scientific explanation consists in the derivation of the explanandum's description from theory (plus antecedent conditions). But in more recent philosophy of science the adequacy of this approach has been challenged, because the relation between theory and phenomena in actual scientific practice turns out to be more intricate. This critique is here examined for an explanatory paradigm that was groundbreaking for 20th century physics and chemistry (and their interrelation): Bohr's first model of the atom and its explanatory relevance for the spectrum of hydrogen. First, the model itself is analysed with respect to the principles and assumptions that enter into its premises. Thereafter, the origin of the model's explanandum is investigated. It can be shown that the explained "phenomenon" is itself the product of a host of modelling accomplishments that stem from an experimental tradition related to 19th century chemistry, viz. spectroscopy. The relation between theory and phenomenon is thus mediated in a twofold way: by (Bohr's) theoretical model and a phenomenological model from spectroscopy. In the final section of the paper an account is outlined that nevertheless permits us to acknowledge this important physico-chemical achievement as a case of (nomological) explanation

A History of Universalism: Conceptions of the Internationality of Science from the Enlightenment to the Cold War

That science is fundamentally universal has been proclaimed innumerable times. But the precise geographical meaning of this universality has changed historically. This article examines conceptions of scientific internationalism from the Enlightenment to the Cold War, and their varying relations to cosmopolitanism, nationalism, socialism, and 'the West'. These views are confronted with recent tendencies to cast science as a uniquely European product

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

Ion implantation of diamond: Damage, doping, and lift-off

In order to make good quality economical diamond electronic devices, it is essential to grow films and to dope these films to obtain n- and p- type conductivity. This review talk discuss first doping by ion implantation plus annealing of the implantation damage, and second flow to make large area single crystal diamonds. C implantation damage below an estimated Frenkel defect concentration of 7% could be recovered almost completely by annealing at 950C. For a defect concentration between 7 and 10%, a stable damage form of diamond (``green diamond``) was formed by annealing. At still higher damage levels, the diamond graphitized. To introduce p-type doping, we have co-implanted B and C into natural diamond at 77K, followed by annealing up to 1100C. The resulting semiconducting material has electrical properties similar to those of natural B-doped diamond. To create n-type diamond, we have implanted Na{sup +}, P+ and As{sup +} ions and have observed semiconducting behavior. This has been compared with carbon or noble element implantation, in an attempt to isolate the effect of radiation damage. Recently, in order to obtain large area signal crystals, we have developed a novel technique for removing thin layers of diamond from bulk or homoepitaxial films. This method consists of ion implantation, followed by selective etching. High energy (4--5 MeV) implantation of carbon or oxygen ions creates a well-defined layer of damaged diamond buried at a controlled depth. This layer is graphitized and selectivity etched either by heating at 550C in an oxygen ambient or by electrolysis. This process successfully lifts off the diamond plate above the graphite layer. The lift-off method, combined with well-established homoepitaxial growth processes, has potential for fabrication of large area single-crystal diamond sheets