Waste the waist: A pilot randomised controlled trial of a primary care based intervention to support lifestyle change in people with high cardiovascular risk

© 2015 Greaves et al. Background: In the UK, thousands of people with high cardiovascular risk are being identified by a national risk-assessment programme (NHS Health Checks). Waste the Waist is an evidence-informed, theory-driven (modified Health Action Process Approach), group-based intervention designed to promote healthy eating and physical activity for people with high cardiovascular risk. This pilot randomised controlled trial aimed to assess the feasibility of delivering the Waste the Waist intervention in UK primary care and of conducting a full-scale randomised controlled trial. We also conducted exploratory analyses of changes in weight. Methods: Patients aged 40-74 with a Body Mass Index of 28 or more and high cardiovascular risk were identified from risk-assessment data or from practice database searches. Participants were randomised, using an online computerised randomisation algorithm, to receive usual care and standardised information on cardiovascular risk and lifestyle (Controls) or nine sessions of the Waste the Waist programme (Intervention). Group allocation was concealed until the point of randomisation. Thereafter, the statistician, but not participants or data collectors were blinded to group allocation. Weight, physical activity (accelerometry) and cardiovascular risk markers (blood tests) were measured at 0, 4 and 12 months. Results: 108 participants (22% of those approached) were recruited (55 intervention, 53 controls) from 6 practices and 89% provided data at both 4 and 12 months. Participants had a mean age of 65 and 70% were male. Intervention participants attended 72% of group sessions. Based on last observations carried forward, the intervention group did not lose significantly more weight than controls at 12 months, although the difference was significant when co-interventions and co-morbidities that could affect weight were taken into account (Mean Diff 2.6Kg. 95%CI: -4.8 to -0.3, p = 0.025). No significant differences were found in physical activity. Conclusions: The Waste the Waist intervention is deliverable in UK primary care, has acceptable recruitment and retention rates and produces promising preliminary weight loss results. Subject to refinement of the physical activity component, it is now ready for evaluation in a full-scale trial

Effect of Bovine Somatotropin on Neutrophil Functions and Clinical Symptoms During Streptococcus uberis Mastitis

The effect of recombinant bovine somatotropin (bST) on the chemiluminescence, diapedesis, and expression of adhesion receptors (CD11a, CD11b, CD18) of isolated polymorphonuclear leukocytes was studied. The plasma concentrations of insulin-like growth factor-I (IGF-I), bST, cortisol, and alpha-lactalbumin were also monitored. In addition, general and local clinical symptoms and the differentiation of circulating leukocytes were also studied during experimentally induced Streptococcus uberis mastitis in cows. Ten cows were infected with 500 cfu of S. uberis O140J in both left quarters. Five cows were subcutaneously treated with 500 mg of recombinant bST 7 d before and after infection, and 5 control cows received the excipient. General (fever, tachycardia, inappetance, and depression) and local symptoms (swelling, pain, firmness, and flecks in milk) were more acute, severe, and longer-lasting in control cows. Treatment with bST had no effect on chemiluminescence and diapedesis of circulating polymorphonuclear leukocytes and no effect on the expression of adhesion receptors. Recombinant bST induced significantly higher IGF-I and bST concentrations in plasma. The leukopenia observed after infection was less pronounced in the bST-treated cows, and the number of circulating band neutrophils and metamyelocytes was significantly lower in the treated group. The concentration of cortisol did not differ between both groups, but the blood concentration of alpha-lactalbumin significantly increased in both groups from 6 d after infection. These results showed that treatment with recombinant bST improves animal welfare by protecting the cows from severe local and general clinical symptoms during subsequent S. uberis mastitis, but that it has no effect on chemiluminescence, diapedesis, and the expression of adhesion receptors of circulating polymorphonuclear leukocytes

DESIGN ISSUES ASSOCIATED WITH NEURAL NETWORK SYSTEMS APPLIED WITHIN THE ELECTRONICS MANUFACTURING DOMAIN

Neural networks have been applied within manufacturing domains, in particular electronics industries, to address the inherent complexity, the large number of interacting process features and the lack of robust analytical models of real industrial processes. The ability of neural systems to provide nonlinear mappings between process features and desired outputs has been the major driving force behind implementations. One of the major issues limiting the widespread industrial uptake of neural systems is the lack of detailed understanding of their design, implementation and operation. In many cases, network topologies and training parameters are systematically varied until satisfactory convergence is achieved. There is little discussion of the rationale behind the adopted training methods. A review of research into the functions that can be readily represented by neural networks are presented in this paper. The application focus is the control and monitoring of a discrete manufacturing process that is part of the manufacturing cycle of mixed technology surface mount printed circuit boards. Detailed knowledge of the process operation and functionality that can be represented by simple network topologies have been combined to develop a structured, partially interconnected neural network that provides optimised convergence performance. A comparison of the designed solution with standard approaches to neural network implementation is given. It has been demonstrated that if there is sufficient confidence in the operation of the process, input feature interaction within the network can be constrained to produce a robust control and monitoring system

Effect of extracellular ionic calcium and magnesium on opsonic and non-opsonic phagocytosis of Escherichia coli bovine blood polymorphonuclear leucocytes.

The effects of extracellular Ca2+ and Mg2+ concentrations on opsonic and non-opsonic phagocytosis of Escherichia call by bovine polymorphonuclear leucocytes (PMN) isolated from blood were evaluated by flow cytometry. Eight cows were used as blood donors. The green fluorescence of blood PMN selectively gated in the forward scatter (FS)- side scatter (SS) dot plot after incubation with fluorescein isothiocyanate (FITC) - labelled E. coli was used to characterise phagocytosis. Parameters for phagocytosis were percentage fluorescent PMN (% phagocytosis) and mean fluorescence intensity (MFI). The fluorescence of adherent bacteria was quenched with trypan blue to distinguish between adherence and ingestion. Nonopsonic and opsonic phagocytosis were decreased in the absence of extracellular ionic Ca2+ and Mg2+ compared to physiological levels. Addition of 10 mM EGTA to the incubation medium was necessary to block all extracellular Ca2+ and resulted in a significant decrease of opsonic phagocytosis, with only 5% phagocytic PMN after quenching. Increasing Ca2+ concentrations resulted in a gradual increase in percentage opsonic and non-opsonic phagocytosis and in MFI for opsonic phagocytosis. Ionic calcium plays an important role in phagocytosis (attachment as well as ingestion) by bovine blood PMN in the presence of opsonins, whereas non-opsonic phagocytosis appeared to be less dependent on Ca2+. However, reduced serum or milk calcium levels in cows are unlikely to cause a substantial reduction of PMN phagocytosis in vivo