Exercise dose and all-cause mortality within extended cardiac rehabilitation: a cohort study.

AIMS: To investigate the relationship between exercise participation, exercise 'dose' expressed as metabolic equivalent (MET) hours (h) per week, and prognosis in individuals attending an extended, community-based exercise rehabilitation programme. METHODS: Cohort study of 435 participants undertaking exercise-based cardiac rehabilitation (CR) in Leeds, West Yorkshire, UK between 1994 and 2006, followed up to 1 November 2013. MET intensity of supervised exercise was estimated utilising serial submaximal exercise test results and corresponding exercise prescriptions. Programme participation was routinely monitored. Cox regression analysis including time-varying and propensity score adjustment was applied to identify predictors of long-term, all-cause mortality across exercise dose and programme duration groups. RESULTS: There were 133 events (31%) during a median follow-up of 14 years (range, 1.2 to 18.9 years). The significant univariate association between exercise dose and all-cause mortality was attenuated following multivariable adjustment for other predictors, including duration in the programme. Longer-term adherence to supervised exercise training (>36 months) was associated with a 33% lower mortality risk (multivariate-adjusted HR: 0.67; 95% CI: 0.47 to 0.97; p=0.033) compared with all lesser durations of CR (3, 12, 36 months), even after adjustment for baseline fitness, comorbidities and survivor bias. CONCLUSION: Exercise dose (MET-h per week) appears less important than long-term adherence to supervised exercise for the reduction of long-term mortality risk. Extended, supervised CR programmes within the community may play a key role in promoting long-term exercise maintenance and other secondary prevention therapies for survival benefit

Submaximal fitness and mortality risk reduction in coronary heart disease: a retrospective cohort study of community-based exercise rehabilitation.

To examine the association between submaximal cardiorespiratory fitness (sCRF) and all-cause mortality in a cardiac rehabilitation (CR) cohort.Retrospective cohort study of participants entering CR between 26 May 1993 and 16 October 2006, followed up to 1 November 2013 (median 14 years, range 1.2-19.4 years).A community-based CR exercise programme in Leeds, West Yorkshire, UK.A cohort of 534 men (76%) and 136 women with a clinical diagnosis of coronary heart disease (CHD), aged 22-82 years, attending CR were evaluated for the association between baseline sCRF and all-cause mortality. 416 participants with an exercise test following CR (median 14 weeks) were examined for changes in sCRF and all-cause mortality.All-cause mortality and change in sCRF expressed in estimated metabolic equivalents (METs).Baseline sCRF was a strong predictor of all-cause mortality; compared to the lowest sCRF group (<5 METs for women and <6 METs for men), mortality risk was 41% lower in those with moderate sCRF (HR 0.59; 95% CI 0.42 to 0.83) and 60% lower (HR 0.40; 95% CI 0.25 to 0.64) in those with higher sCRF levels (≥7 METs women and ≥8 METs for men). Although improvement in sCRF at 14 weeks was not associated with a significant mortality risk reduction (HR 0.91; 95% CI 0.79 to 1.06) for the whole cohort, in those with the lowest sCRF (and highest all-cause mortality) at baseline, each 1-MET improvement was associated with a 27% age-adjusted reduction in mortality risk (HR 0.73; 95% CI 0.57 to 0.94).Higher baseline sCRF is associated with a reduced risk of all-cause mortality over 14 years in adults with CHD. Improving fitness through exercise-based CR is associated with significant risk reduction for the least fit

Characteristics, accuracy and reverification of robotised articulated arm CMMs

VDI article 2617 specifies characteristics to describe the accuracy of articulated arm coordinate measuring machines (AACMMs) and outlines procedures for checking them. However the VDI prescription was written with a former generation of machines in mind: manual arms exploiting traditional touch probe technologies. Recent advances in metrology have given rise to noncontact laser scanning tools and robotic automation of articulated arms – technologies which are not adequately characterised using the VDI specification. In this paper we examine the “guidelines” presented in VDI 2617, finding many of them to be ambiguous and open to interpretation, with some tests appearing even to be optional. The engineer is left significant flexibility in the execution of the test procedures and the manufacturer is free to specify many of the test parameters. Such flexibility renders the VDI tests of limited value and the results can be misleading. We illustrate, with examples using the Nikon RCA, how a liberal interpretation of the VDI guidelines can significantly improve accuracy characterisation and suggest ways in which to mitigate this problem. We propose a series of stringent tests and revised definitions, in the same vein as VDI 2617 and similar US standards, to clarify the accuracy characterisation process. The revised methodology includes modified acceptance and reverification tests which aim to accommodate emerging technologies, laser scanning devices in particular, while maintaining the spirit of the existing and established standards. We seek to supply robust re-definitions for the accepted terms “zero point” and “useful arm length”, pre-supposing nothing about the geometry of the measuring device. We also identify a source of error unique to robotised AACMMs employing laser scanners – the forward-reverse pass error. We show how eliminating this error significantly improves the repeatability of a device and propose a novel approach to the testing of probing error based on statistical uncertainty

Strongly Bound Surface Water Affects the Shape Evolution of Cerium Oxide Nanoparticles

The surface structure and composition of functional materials are well-known to be critically important factors controlling the surface reactivity. However, when doped the surface composition will change, and the challenge is to identify its impact on important surface processes and nanoparticle morphologies. We have begun to address this by using a combination of density functional theory and potential-based methods to investigate the effect of surface dopants on water adsorption and morphology of the technologically important material, CeO$_2$, which finds application as electrolyte in SOFCs, catalyst in soot combustion, and enzyme mimetic agents in biomedicine. We show that by mapping CeO$_2$ surface phase diagrams we can predict nanoparticle morphologies as a function of dopant, temperature, and water partial pressure. Our results show that low-temperature, undoped CeO$_2$ nanocubes with active {100} surface sites are thermodynamically stable, but at the typical high temperature, operating conditions favor polyhedra where {100} surfaces are replaced by less active {111} surfaces by surface ion migration. However, doping with trivalent cations, such as Gd$^{3+}$, will increase binding of water on the {100} surfaces and hence act to preserve the cuboidal architecture by capping the active surfaces. As surfaces tend to be decorated by impurities and dopants it is clear that their role should receive more attention and the approach we describe can be routinely applied to nanomaterials, morphologies, and associated active/inactive surfaces

Ultrasonography of the prostate gland and testes in dogs

Ultrasonographic imaging is an important diagnostic tool because it allows assessment of the shape, size, position, margination and internal architecture of organs, as well as facilitating the study of vascular supply and vascularisation. Recently, there has been considerable development of B-mode, Doppler and contrast-enhanced ultrasonography for examination of the reproductive tract of dogs, both for studying normal physiology and in the clinical setting. This article describes the practical examination of the canine prostate gland and testes using a variety of ultrasound techniques, and details the normal appearance and blood flow of these organs as well as changes that may be observed with common reproductive disorders

Communications Biophysics

Contains reports on four research projects.National Institutes of Health (Grant 1 P01 GM-14940-02)Joint Services Electronics Programs (U. S. Army, U. S. Navy, and U. S. Air Force) under Contract DA 28-043-AMC-02536(E)National Institutes of Health (Grant 5 TO1 GM-01555-02

ENDF-6 compatible evaluation of neutron induced reaction cross sections for 106,108,110,111,112,113,114,116Cd

An ENDF-6 compatible evaluation for neutron induced reactions in the resonance region has been completed for 106,108,110,111,112,113,114,116Cd. The parameters are the result of an analysis of experimental data available in the literature together with a parameter adjustment on transmission and capture data obtained at the time-of-flight facility GELINA. Complete evaluated data files in ENDF-6 format have been produced by joining the evaluations in the resonance region with corresponding files from the JEFF-3.1.2 nuclear data library (or with the JEFF-Beta-CAD proposed evaluation in case of 113Cd). These files were produced for use in the JEFF32T2 library. For neutron induced reactions in the unresolved resonance region the JENDL-4.0 evaluation for 111Cd and 113Cd was adopted. The evaluated files have been processed with the latest updates of NJOY.99 to test their format and application consistency as well as to produce a continuous-energy data library in ACE format for use in Monte Carlo codes. The ACE files have been utilized to study the effect of the evaluated resonance parameters on results of integral experiments. The evaluated files will be implemented in the next release of the JEFF-3 library which is maintained by the Nuclear Energy Agency of the OECD.JRC.D.4-Standards for Nuclear Safety, Security and Safeguard

Laboratory evidence of disseminated intravascular coagulation is associated with a fatal outcome in children with cerebral malaria despite an absence of clinically evident thrombosis or bleeding

Background A procoagulant state is implicated in cerebral malaria (CM ) pathogenesis, but whether disseminated intravascular coagulation (DIC ) is present or associated with a fatal outcome is unclear. Objectives To determine the frequency of overt DIC , according to ISTH criteria, in children with fatal and non‐fatal CM . Methods/patients Malawian children were recruited into a prospective cohort study in the following diagnostic groups: retinopathy‐positive CM (n = 140), retinopathy‐negative CM (n = 36), non‐malarial coma (n = 14), uncomplicated malaria (UM ), (n = 91), mild non‐malarial febrile illness (n = 85), and healthy controls (n = 36). Assays in the ISTH DIC criteria were performed, and three fibrin‐related markers, i.e. protein C, antithrombin, and soluble thrombomodulin, were measured. Results and conclusions Data enabling assignment of the presence or absence of ‘overt DIC ’ were available for 98 of 140 children with retinopathy‐positive CM . Overt DIC was present in 19 (19%), and was associated with a fatal outcome (odds ratio [OR] 3.068; 95% confidence interval [CI] 1.085–8.609; P = 0.035]. The levels of the three fibrin‐related markers and soluble thrombomodulin were higher in CM patients than in UM patients (all P < 0.001). The mean fibrin degradation product level was higher in fatal CM patients (71.3 μg mL−1 [95% CI 49.0–93.6]) than in non‐fatal CM patients (48.0 μg mL−1 [95% CI 37.7–58.2]; P = 0.032), but, in multivariate logistic regression, thrombomodulin was the only coagulation‐related marker that was independently associated with a fatal outcome (OR 1.084 for each ng mL−1 increase [95% CI 1.017–1.156]; P = 0.014). Despite these laboratory derangements, no child in the study had clinically evident bleeding or thrombosis. An overt DIC score and high thrombomodulin levels are associated with a fatal outcome in CM , but infrequently indicate a consumptive coagulopathy

Surfaces roughness effects on the transmission of Gaussian beams by anisotropic parallel plates

Influence of the plate surfaces roughness in precise ellipsometry experiments is studied. The realistic case of a Gaussian laser beam crossing a uniaxial platelet is considered. Expression for the transmittance is determined using the first order perturbation theory. In this frame, it is shown that interference takes place between the specular transmitted beam and the scattered field. This effect is due to the angular distribution of the Gaussian beam and is of first order in the roughness over wavelength ratio. As an application, a numerical simulation of the effects of quartz roughness surfaces at normal incidence is provided. The interference term is found to be strongly connected to the random nature of the surface roughness.Comment: 18 pages, Journal of Physics D: Applied Physics, volume 36, issue 21, pages 2697 - 270