Assessment of HRV After Maximal Exercise in Trained Postmenopausal Women

Increased parasympathetic tone achieved with endurance training may provide cardioprotection after menopause. To compare heart rate variability (HRV) from rest through maximal exercise and recovery in trained postmenopausal women. Thirtysix postmenopausal women who self-reported training at either moderate (MOD; 3-5.9 METS; 58.9±4.4 year) or vigorous (VIG; \u3e6 METS; 59.7±5.2 year) intensities participated. HRV was measured for 5 min in the supine position, in the last minute of the VO2max test and after 2 min of active recovery. HRV in MOD and VIG was compared using a factorial ANOVA with repeated measures on time. MOD and VIG responded similarly over the three time periods for root mean square of sequential deviations (rMSSD), and high (HF) and low frequency (LF) power (p\u3e0.05). Maximal exercise lowered rMSSD (3.3±0.08 vs. 1.2±0.06) and lnLF (4.1±0.05 vs. 3.3±0.13) and increased lnHF (3.3±0.14 vs. 4.0±0.10; p\u3c0.01) from resting. However, active recovery restored lnHF (3.3±0.11) and lnLF (4.1±0.08) from maximal values (p\u3c0.01). Our findings suggest that moderate and vigorous exercise training may enhance HRV recovery following one bout of maximal exercise in older women

Optimization with gradient-boosted trees and risk control

Decision trees effectively represent the sparse, high dimensional and noisy nature of chemical data from experiments. Having learned a function from this data, we may want to thereafter optimize the function, e.g., picking the best chemical process catalyst. In this way, we may repurpose legacy predictive models. This work studies a large-scale, industrially-relevant mixed-integer quadratic optimization problem involving: (i) gradient-boosted pre-trained regression trees modeling catalyst behavior, (ii) penalty functions mitigating risk, and (iii) penalties enforcing composition constraints. We develop heuristic methods and an exact, branch-and-bound algorithm leveraging structural properties of gradient-boosted trees and penalty functions. We numerically test our methods on an industrial instance

Is Vigorous Exercise Training Superior to Moderate for CVD Risk after Menopause?

Postmenopausal women have an increased risk for cardiovascular disease through many factors, such as a sedentary lifestyle and reduced heart rate variability (HRV). Endurance training improves coronary risk but the role of exercise intensity is unclear. The purpose of this observational study was to evaluate the effects of moderate versus vigorous exercise on cardiovascular disease risk in postmenopausal women. Thirty-six postmenopausal women who self-reported training at moderate (3–5.9 METS; n = 18; age 58.9 ± 4.4yr) or vigorous intensities ( \u3e 6 METS; n = 18; age 59.7 ± 5.2yr) participated. C-reactive protein (CRP), HRV, VO2max, and stress (Perceived Stress Survey, Menopause Rating Scale) were measured. Groups were compared using independent samples t-tests, and associations of exercise intensities with CRP and HRV were assessed using multiple regression. CRP, HRV, and VO2max were similar (p \u3e 0.05). Vigorous exercise had lower stress subscale scores (p \u3c 0.01) and higher counter-stress subscale scores compared to moderate (p \u3c 0.05). There was a positive association between time spent in vigorous exercise and HRV (p \u3c 0.05).Vigorous exercise may not confer additional benefits in CRP and HRV over moderate, except for stress reduction. However, more time spent in vigorous exercise was associated with higher HRV. Therefore, increased parasympathetic tone may provide cardioprotection after menopause

Current state of antimicrobial stewardship in children’s hospital emergency departments

BACKGROUND Antimicrobial stewardship programs (ASPs) effectively optimize antibiotic use for inpatients; however, the extent of emergency department (ED) involvement in ASPs has not been described. OBJECTIVE To determine current ED involvement in children's hospital ASPs and to assess beliefs and preferred methods of implementation for ED-based ASPs. METHODS A cross-sectional survey of 37 children's hospitals participating in the Sharing Antimicrobial Resistance Practices collaboration was conducted. Surveys were distributed to ASP leaders and ED medical directors at each institution. Items assessed included beliefs regarding ED antibiotic prescribing, ED prescribing resources, ASP methods used in the ED such as clinical decision support and clinical care guidelines, ED participation in ASP activities, and preferred methods for ED-based ASP implementation. RESULTS A total of 36 ASP leaders (97.3%) and 32 ED directors (86.5%) responded; the overall response rate was 91.9%. Most ASP leaders (97.8%) and ED directors (93.7%) agreed that creation of ED-based ASPs was necessary. ED resources for antibiotic prescribing were obtained via the Internet or electronic health records (EHRs) for 29 hospitals (81.3%). The main ASP activities for the ED included production of antibiograms (77.8%) and creation of clinical care guidelines for pneumonia (83.3%). The ED was represented on 3 hospital ASP committees (8.3%). No hospital ASPs actively monitored outpatient ED prescribing. Most ASP leaders (77.8%) and ED directors (81.3%) preferred implementation of ED-based ASPs using clinical decision support integrated into the EHR. CONCLUSIONS Although ED involvement in ASPs is limited, both ASP and ED leaders believe that ED-based ASPs are necessary. Many children's hospitals have the capability to implement ED-based ASPs via the preferred method: EHR clinical decision support. Infect Control Hosp Epidemiol 2017;38:469-475

Androgens Tend to Be Higher, but What about Altered Progesterone Metabolites in Boys and Girls with Autism?

BACKGROUND Evidence exists that steroid hormones are altered in individuals with autism, especially androgens. Despite lower prevalence in girls than boys, evidence of potential alterations in progesterone metabolites is sparse, so the aim of this study was to elucidate different progesterone metabolites in affected children with autism versus healthy controls. MATERIAL AND METHODS Circadian urine samples from 48 boys and 16 girls with autism spectrum disorders and a matched case-control group were analysed for progesterone metabolites by gas chromatography-mass spectrometry and normalised for creatinine excretion. RESULTS In boys with autism, the majority of progesterone metabolites were reduced, such as progesterone, 6a-OH-3a5b-TH-progesterone, or 20a-DH-progesterone (p < 0.01 for all). In girls with autism, a similar pattern of reduction in progesterone metabolites was detected; however, potentially due to the relatively small sample, this pattern was only detectable on the level of a trend. DISCUSSION As stated, androgen levels are higher in boys and girls with autism, but evidence for progesterone metabolites is much sparser. The pattern of a decrease in progesterone metabolites suggests the existence of an altered routing of steroid metabolites, probably in combination with a dysregulation of the HPAG axis. As, recently, increased CYP17A1 activity has been suggested, the stronger routing towards androgens is further implied in line with our findings of lower progesterone concentrations in boys and girls with autism than healthy controls

Origin of trap assisted tunnelling in ammonia annealed SiC trench MOSFETs

The interface between silicon carbide (SiC) and silicon dioxide (SiO2) is of considerable importance for the performance and reliability of 4H-SiC (trench) metal oxide semiconductor field effect transistors (MOSFETs) and various different post oxidation anneals (POAs) have been used to optimize its quality. Whereas nitric oxide (NO) POA leads to very reliable and well performing MOSFETs, ammonia (NH3) can further improve the device performance, however, at the cost of the gate oxide (GOX) reliability, e.g. leading to trap assisted tunneling (TAT). We investigate the origin of TAT and GOX leakage in differently annealed gate oxides experimentally, using 4H-SiC trench MOSFETs, and theoretically, using Density Functional Theory (DFT) simulations. Our findings reinforce the view that the NO anneal for SiC devices results in the best overall quality as devices annealed in NH3 and nitrogen N2 show higher oxide charge density and leakage currents. DFT simulations demonstrate that, contrary to what has often been assumed so far, NH3 annealing leads to the formation of additional hydrogen related defects, which open leakage paths in the oxide otherwise not present in NO treated oxides

Reconstructing communities in cluster trials?

BACKGROUND: There is growing interest in the ethics of cluster trials, but no literature on the uncertainties in defining communities in relation to the scientific notion of the cluster in collaborative biomedical research. METHODS: The views of participants in a community-based cluster randomised trial (CRT) in Mumbai, India, were solicited regarding their understanding and views on community. We conducted two focus group discussions with local residents and 20 semi-structured interviews with different respondent groups. On average, ten participants took part in each focus group, most of them women aged 18-55. We conducted semi-structured interviews with ten residents (nine women and one man) lasting approximately an hour each and seven individuals (five men and two women) identified by residents as local leaders or decision-makers. In addition, we interviewed two Municipal Corporators (locally elected government officials involved in urban planning and development) and one representative of a political party located in a slum community. RESULTS: Residents' sense of community largely matched the scientific notion of the cluster, defined by the investigators as a geographic area, but their perceived needs were not entirely met by the trial. CONCLUSION: We examined whether the possibility of a conceptual mismatch between 'clusters' and 'communities' is likely to have methodological implications for a study or to lead to potential social disharmony because of the research interventions, arguing that it is important to take social factors into account as well as statistical efficiency when choosing the size and type of clusters and designing a trial. One method of informing such a design would be to use existing forums for community engagement to explore individuals' primary sense of community or social group and, where possible, to fit clusters around them. TRIAL REGISTRATION: ISRCTN Register: ISRCTN56183183 Clinical Trials Registry of India: CTRI/2012/09/003004

Raman and nuclear magnetic resonance investigation of alkali metal vapor interaction with alkene-based anti-relaxation coating

The use of anti-relaxation coatings in alkali vapor cells yields substantial performance improvements by reducing the probability of spin relaxation in wall collisions by several orders of magnitude. Some of the most effective anti-relaxation coating materials are alpha-olefins, which (as in the case of more traditional paraffin coatings) must undergo a curing period after cell manufacturing in order to achieve the desired behavior. Until now, however, it has been unclear what physicochemical processes occur during cell curing, and how they may affect relevant cell properties. We present the results of nondestructive Raman-spectroscopy and magnetic-resonance investigations of the influence of alkali metal vapor (Cs or K) on an alpha-olefin, 1-nonadecene coating the inner surface of a glass cell. It was found that during the curing process, the alkali metal catalyzes migration of the carbon-carbon double bond, yielding a mixture of cis- and trans-2-nonadecene.Comment: 5 pages, 6 figure