High-intensity interval training produces a significant improvement in fitness in less than 31 days before surgery for urological cancer: a randomised control trial

ObjectivesTo assess the efficacy of high-intensity interval training (HIIT) for improving cardiorespiratory fitness (CRF) in patients awaiting resection for urological malignancy within four weeks.Subjects/patients and methodsA randomised control trial of consecutive patients aged (>65 years) scheduled for major urological surgery in a large secondary referral centre in a UK hospital. The primary outcome is change in anaerobic threshold (VO2AT) following HIIT vs. standard care.ResultsForty patients were recruited (mean age 72 years, male (39): female (1)) with 34 completing the protocol. Intention to treat analysis showed significant improvements in anaerobic threshold (VO2AT; mean difference (MD) 2.26 ml/kg/min (95% CI 1.25–3.26)) following HIIT. Blood pressure (BP) also significantly reduced in following: HIIT (SBP: −8.2 mmHg (95% CI −16.09 to −0.29) and DBP: −6.47 mmHg (95% CI −12.56 to −0.38)). No reportable adverse safety events occurred during HIIT and all participants achieved >85% predicted maximum heart rate during sessions, with protocol adherence of 84%.ConclusionsHIIT can improve CRF and cardiovascular health, representing clinically meaningful and achievable pre-operative improvements. Larger randomised trials are required to investigate the efficacy of prehabilitation HIIT upon different cancer types, post-operative complications, socio-economic impact and long-term survival

Intergenerational perceptions of household wellbeing in India’s Western and Eastern Ghats

India is home to the largest number of people living in poverty in the world. To inform poverty alleviation strategies, we sought local insights on wellbeing trajectories from three generations of respondents in three communities in the Western and Eastern Ghats. An integrated thematic analysis was carried out using qualitative information from focus group discussions (FGDs) and a survey instrument. Overall, we found most households had a positive perspective regarding their wellbeing over time; when divided into research locations, the Odisha site (Jeypore) was the most optimistic, the Kerala site (Wayanad) had no consensus position, and the Tamil Nadu site (Kolli Hills) was most pessimistic. Scheduled tribe (ST) and non-ST households were similar in their wellbeing perceptions despite the ongoing social and economic marginalization of ST households. Common negative events experienced were health (death or alcoholism) and climate disasters (drought or flooding), and common positive events were asset inheritance or government schemes. An important insight was changing importance of events between generations: elder generations valued labour migration, interim generations valued asset inheritance, and the current generation valued government schemes. We conclude that significant events play a major role in wellbeing perceptions among these communities, and understanding the evolving forms of significant events between generations can provide insights towards designing effective poverty alleviation strategies for the future

GWAS Identifies 44 Independent Associated Genomic Loci for Self-Reported Adult Hearing Difficulty in UK Biobank

Age-related hearing impairment (ARHI) is the most common sensory impairment in the aging population; a third of individuals are affected by disabling hearing loss by the age of 65. It causes social isolation and depression and has recently been identified as a risk factor for dementia. The genetic risk factors and underlying pathology of ARHI are largely unknown, meaning that targets for new therapies remain elusive, yet heritability estimates range between 35% and 55%. We performed genome-wide association studies (GWASs) for two self-reported hearing phenotypes, using more than 250,000 UK Biobank (UKBB) volunteers aged between 40 and 69 years. Forty-four independent genome-wide significant loci (p < 5E−08) were identified, considerably increasing the number of established trait loci. Thirty-four loci are novel associations with hearing loss of any form, and only one of the ten known hearing loci has a previously reported association with an ARHI-related trait. Gene sets from these loci are enriched in auditory processes such as synaptic activities, nervous system processes, inner ear morphology, and cognition, while genetic correlation analysis revealed strong positive correlations with multiple personality and psychological traits for the first time. Immunohistochemistry for protein localization in adult mouse cochlea implicate metabolic, sensory, and neuronal functions for NID2, CLRN2, and ARHGEF28. These results provide insight into the genetic landscape underlying ARHI, opening up novel therapeutic targets for further investigation. In a wider context, our study also highlights the viability of using self-report phenotypes for genetic discovery in very large samples when deep phenotyping is unavailable

The (Re-)Discovery of G350.1-0.3: A Young, Luminous Supernova Remnant and Its Neutron Star

We present an XMM-Newton observation of the long-overlooked radio source G350.1-0.3. The X-ray spectrum of G350.1-0.3 can be fit by a shocked plasma with two components: a high-temperature (1.5 keV) region with a low ionization time scale and enhanced abundances, plus a cooler (0.36 keV) component in ionization equilibrium and with solar abundances. The X-ray spectrum and the presence of non-thermal, polarized, radio emission together demonstrate that G350.1-0.3 is a young, luminous supernova remnant (SNR), for which archival HI and 12-CO data indicate a distance of 4.5 kpc. The diameter of the source then implies an age of only ~900 years. The SNR's distorted appearance, small size and the presence of 12-CO emission along the SNR's eastern edge all indicate that the source is interacting with a complicated distribution of dense ambient material. An unresolved X-ray source, XMMU J172054.5-372652, is detected a few arcminutes west of the brightest SNR emission. The thermal X-ray spectrum and lack of any multi-wavelength counterpart suggest that this source is a neutron star associated with G350.1-0.3, most likely a "central compact object", as seen coincident with other young SNRs such as Cassiopeia A.Comment: 6 pages, uses emulateapj. One B/W figure, one color figure. Minor text changes and update to Fig 2 following referee's report. ApJ Letters, in pres

Evaluation of MOSFETs for entrance dose dosimetry for 6 and 10 MV photons with a custom made build up cap

Copyright © 2007 ACPSEM. All rights reserved. The dcoument attached has been archived with permission from the publisher.Commercially available MOSFETs, Thomson and Nielsen TN502-RD, were evaluated for suitability as an entrance dose in vivo dosimeter for 6MV and 10MV. Detector response was normally distributed around a mean (skewness=-0.01±0.24, kurtosis=-0.09±0.48) with a mean of 110.6 mV/Gy, with a standard deviation of 2.4% at 0.86 Gy. The standard deviation of readings increased with decreasing dose and increased at a rate greater than inverse square. The linearity coefficient was 0.9999. No significant dependence on angle, field size, dose rate, energy or time was observed. As such, they would be useful for entrance dose in vivo dosimetry. With a custom made build up cap corrections were required for field size, wedge, beam energy and tray factors, showing that build up cap design is an important consideration for entrance dose in vivo dosimetry using MOSFETs.J. P. Morton, M. Bhat, A. Kovendy and T. Williamshttp://www.acpsem.org.au/journal/abstract/abstract_3002.html#abs0

Anthropology, Brokerage and Collaboration in the development of a Tongan Public Psychiatry: Local Lessons for Global Mental Health

The Global Mental Health (GMH) movement has revitalised questions of the translatability of psychiatric concepts and the challenges of community engagement in countries where knowledge of the biomedical basis for psychiatric diagnosis is limited or challenged by local cultural codes. In Tonga, the local psychiatrist Dr Puloka has successfully established a publicly accessible psychiatry that has raised admission rates for serious mental illness and addressed some of the stigma attached to diagnosis. On the basis of historical analysis and ethnographic fieldwork with healers, doctors and patients since 1998, this article offers an ethnographic contextualization of the development and reception of three key interventions during the 1990s inspired by traditional healing and reliant on the translation of psychiatric terms and diagnosis. Dr Puloka’s use of medical anthropological and transcultural psychiatry research informed a community engaged brokerage between the implications of psychiatric nosologies and local needs. As such it reveals deficiencies in current polarised positions on the GMH project and offers suggestions to address current challenges of the Global Mental Health movement

Appetite and gut hormone responses to moderate-intensity continuous exercise versus high-intensity interval exercise, in normoxic and hypoxic conditions.

This study investigated the effects of continuous moderate-intensity exercise (MIE) and high-intensity interval exercise (HIIE) in combination with short exposure to hypoxia on appetite and plasma concentrations of acylated ghrelin, peptide YY (PYY), and glucagon-like peptide-1 (GLP-1). Twelve healthy males completed four, 2.6 h trials in a random order: 1) MIE-normoxia, 2) MIE-hypoxia, 3) HIIE-normoxia, and 4) HIIE-hypoxia. Exercise took place in an environmental chamber. During MIE, participants ran for 50 min at 70% of altitude-specific maximal oxygen uptake ( 2max) and during HIIE performed 6 x 3 min running at 90% 2max interspersed with 6 x 3 min active recovery at 50% 2max with a 7 min warm-up and cool-down at 70% 2max (50 min total). In hypoxic trials, exercise was performed at a simulated altitude of 2,980 m (14.5% O2). Exercise was completed after a standardised breakfast. A second meal standardised to 30% of participants’ daily energy requirements was provided 45 min after exercise. Appetite was suppressed more in hypoxia than normoxia during exercise, post-exercise, and for the full 2.6 h trial period (linear mixed modelling, p 0.05). These findings demonstrate that short exposure to hypoxia causes suppressions in appetite and plasma acylated ghrelin concentrations. Furthermore, appetite responses to exercise do not appear to be influenced by exercise modality

PRESENT 2020: Text Expanding on the Checklist for Proper Reporting of Evidence in Sport and Exercise Nutrition Trials.

Some readers may not have access to the full paper, so a properly formatted and well-written abstract is imperative. Authors should give priority to information about the current study rather than using the abstract for an extensive background or rationale. 2a Methods: Key information regarding the study design, methods, and population should be summarized to enable broad understanding of the study from the abstract. 2b Results: Readers are interested in extracting key data that reflect the main findings of the study. The abstract should present data (e.g., the absolute magnitude of values and the size/precision of effects—specifying which measures of central tendency and variability are stated) rather than simply stating the presence, absence, or direction of effects. The presentation of p values or similar inferential statistics is no substitute for reporting actual data (Maughan, 2004). 2c Conclusion: Priority should be given to the reporting of results as per the previous section, with only a brief concluding statement thereafter. A concise conclusion based on what was actually measured in the study is preferred to speculative interpretations, with cautious use of language to avoid hyperbole or improper inference of causality (Brown et al., 2013). It is not appropriate or necessary to identify further research priorities here

Home and Online Management and Evaluation of Blood Pressure (HOME BP) using a digital intervention in poorly controlled hypertension: randomised controlled trial

Objective: The HOME BP (Home and Online Management and Evaluation of Blood Pressure) trial aimed to test a digital intervention for hypertension management in primary care by combining self-monitoring of blood pressure with guided self-management. Design: Unmasked randomised controlled trial with automated ascertainment of primary endpoint. Setting: 76 general practices in the United Kingdom. Participants: 622 people with treated but poorly controlled hypertension (>140/90 mm Hg) and access to the internet. Interventions: Participants were randomised by using a minimisation algorithm to self-monitoring of blood pressure with a digital intervention (305 participants) or usual care (routine hypertension care, with appointments and drug changes made at the discretion of the general practitioner; 317 participants). The digital intervention provided feedback of blood pressure results to patients and professionals with optional lifestyle advice and motivational support. Target blood pressure for hypertension, diabetes, and people aged 80 or older followed UK national guidelines. Main outcome measures: The primary outcome was the difference in systolic blood pressure (mean of second and third readings) after one year, adjusted for baseline blood pressure, blood pressure target, age, and practice, with multiple imputation for missing values. Results: After one year, data were available from 552 participants (88.6%) with imputation for the remaining 70 participants (11.4%). Mean blood pressure dropped from 151.7/86.4 to 138.4/80.2 mm Hg in the intervention group and from 151.6/85.3 to 141.8/79.8 mm Hg in the usual care group, giving a mean difference in systolic blood pressure of −3.4 mm Hg (95% confidence interval −6.1 to −0.8 mm Hg) and a mean difference in diastolic blood pressure of −0.5 mm Hg (−1.9 to 0.9 mm Hg). Results were comparable in the complete case analysis and adverse effects were similar between groups. Within trial costs showed an incremental cost effectiveness ratio of £11 ($15, €12; 95% confidence interval £6 to £29) per mm Hg reduction. Conclusions: The HOME BP digital intervention for the management of hypertension by using self-monitored blood pressure led to better control of systolic blood pressure after one year than usual care, with low incremental costs. Implementation in primary care will require integration into clinical workflows and consideration of people who are digitally excluded. Trial registration: ISRCTN13790648