Peak Ventilation Reference Standards from Exercise Testing: From the FRIEND Registry

Peak Ventilation Reference Standards from Exercise Testing: From the FRIEND Registry. Med. Sci. Sports Exerc., Vol. 50, No. 12, pp. 2603–2608, 2018. Purpose: Cardiopulmonary exercise testing (CPX) provides valuable clinical information, including peak ventilation (V˙ Epeak), which has been shown to have diagnostic and prognostic value in the assessment of patients with underlying pulmonary disease. This report provides reference standards for V˙ Epeak derived from CPX on treadmills in apparently healthy individuals. Methods: Nine laboratories in the United States experienced in CPX administration with established quality control procedures contributed to the Fitness Registry and the Importance of Exercise National Database from 2014 to 2017. Data from 5232 maximal exercise tests from men and women without cardiovascular or pulmonary disease were used to create percentiles ofV˙ Epeak for both men and women by decade between 20 and 79 yr. Additionally, prediction equations were developed for V˙ Epeak using descriptive information. Results: V˙ Epeak was found to be significantly different between men and women and across age groups (P G 0.05). The rate of decline in V˙ Epeak was 8.0% per decade for both men and women. A stepwise regression model of 70% of the sample revealed that sex, age, and height were significant predictors ofV˙ Epeak. The equation was cross-validated with data from the remaining 30% of the sample with a final equation developed from the full sample (r = 0.73). Additionally, a linear regression model revealed forced expiratory volume in 1 s significantly predicted V˙ Epeak (r = 0.73). Conclusions: Reference standards were developed for V˙ Epeak for the United States population. Cardiopulmonary exercise testing laboratories will be able to provide interpretation of V˙ Epeak from these age and sex-specific percentile reference values or alternatively can use these nonexercise prediction equations incorporating sex, age, and height or with a single predictor of forced expiratory volume in 1 s

A Cross-Sectional Study Exploring the Physical Activity Levels of Afghans and Other South Asian Youth in the UK

Introduction: Participating in regular physical activity (PA) has numerous benefits, such as reducing obesity, chronic degenerative conditions, and depression. Despite many health-related benefits, physical inactivity is increasing in young people worldwide, especially in ethnic minority groups, such as British South Asians (BSAs). The aim of this study was to explore the PA levels of BSAs, specifically focusing on youth from Afghan, Pakistani, Bangladeshi, and Indian groups. Methods: A total of 191 (Afghans N = 44; Bangladeshi N = 39; Indian N = 56, Pakistani N = 52) youth from the West Midlands (UK) participated in this study (mean age 15.4 ± 0.5). The International Physical Activity Questionnaire—Short Form was used to measure PA levels. Data were modelled using a Bayesian approach to determine differences in PA levels. Results: The results indicated that 88.5% Afghans, 80% Bangladeshi, 78.6% Indians and 63% Pakistani reported engaging in <30 min of PA per day. Additionally, boys were more active than girls across all ethnic groups. Discussion: This study highlighted an alarmingly low proportion of young people from each BSA ethnic group meeting the PA guidelines. To the authors’ knowledge, this is the first study to explore and compare PA levels of the young British Afghan population, thus contributing novel findings to the area of BSA PA. Conclusion: Overall, the vast majority of BSA young people failed to meet the recommended PA guidelines of 60 min per day. Future research could utilise objective methods, such as Global Positioning System, pedometers and accelerometery to track and monitor PA levels, and could adopt an ecological approach to explore determinants of PA within each ethnic and gender group

Patients avoided important care during the early weeks of the coronavirus pandemic: diverticulitis patients were more likely to present with an abscess on CT

PURPOSE: To evaluate the frequency with which patients with an urgent health concern, specifically diverticulitis, avoided appropriate medical care during the early weeks of the coronavirus pandemic of 2020 and to study the consequences of the resultant delay in care, the incidence of an associated abscess. METHODS: This study was institutional review board approved. Reports for CT studies with findings of newly diagnosed diverticulitis within Henry Ford Health System during the early weeks of the coronavirus pandemic of 2020 were reviewed and compared with the same time period in 2019. Total cases of diverticulitis on CT were compared, as well as the prevalence of an associated abscess. A chi-squared analysis was performed to determine the statistical significance of the percentage of patients presenting with an abscess in each year. RESULTS: During the early weeks of the coronavirus pandemic, 120 patients were identified with CT findings of newly diagnosed diverticulitis with 11.7% of those patients (14 patients) presenting with an associated abscess. During the same time period in 2019, many more CT studies with newly diagnosed diverticulitis were obtained (339), and, compared to 2020, less than half the percentage of those patients had an associated abscess (4.4% or 15 patients). CONCLUSION: Patients with urgent health concerns avoided appropriate and necessary care during the early weeks of the coronavirus pandemic. While non-COVID-19 emergency visits were diminished, patients who did present with diverticulitis were more likely to present with greater disease severity as manifested by an associated abscess. Patients must be encouraged to seek care when appropriate and need reassurance that hospitals and their emergency departments are safe to visit. Furthermore, emergency physicians and radiologists in particular should be vigilant during times when emergency volumes are low, such as a future surge in coronavirus patients, other pandemics, snow storms, and holidays as the patients who do present for care are more likely to present at later stages and with serious complications

From finite nuclei to the nuclear liquid drop: leptodermous expansion based on the self-consistent mean-field theory

The parameters of the nuclear liquid drop model, such as the volume, surface, symmetry, and curvature constants, as well as bulk radii, are extracted from the non-relativistic and relativistic energy density functionals used in microscopic calculations for finite nuclei. The microscopic liquid drop energy, obtained self-consistently for a large sample of finite, spherical nuclei, has been expanded in terms of powers of A^{-1/3} (or inverse nuclear radius) and the isospin excess (or neutron-to-proton asymmetry). In order to perform a reliable extrapolation in the inverse radius, the calculations have been carried out for nuclei with huge numbers of nucleons, of the order of 10^6. The Coulomb interaction has been ignored to be able to approach nuclei of arbitrary sizes and to avoid radial instabilities characteristic of systems with very large atomic numbers. The main contribution to the fluctuating part of the binding energy has been removed using the Green's function method to calculate the shell correction. The limitations of applying the leptodermous expansion to actual nuclei are discussed. While the leading terms in the macroscopic energy expansion can be extracted very precisely, the higher-order, isospin-dependent terms are prone to large uncertainties due to finite-size effects.Comment: 13 pages revtex4, 7 eps figures, submitted to Phys. Rev.

A Survey for Infall Motions toward Starless Cores. II. CS(2−1)CS (2-1) and N2H+(1−0)N_2H^+ (1-0) Mapping Observations

We present the results of an extensive mapping survey of 53 `starless' cores in the optically thick line of CS 2-1 and the optically thin lines of N2H+ 1-0 and C18O 1-0. The purpose of this survey was to search for signatures of extended inward motions. This study finds 10 `strong' and 9 `probable' infall candidates, based on $\delta V_{CS}$ analysis and on the spectral shapes of CS lines. From our analysis of the blue-skewed CS spectra and the $\delta V_{CS}$ parameter, we find typical infall radii of 0.06-0.14 pc. Also, using a simple two layer radiative transfer model to fit the profiles, we derive one-dimensional infall speeds, half of whose values lie in the range of 0.05-0.09 km s$^{-1}$. These values are similar to those found in L1544 by Tafalla et al., and this result confirms that infall speeds in starless cores are generally faster than expected from ambipolar diffusion in a strongly sub-critical core. In addition, the observed infall regions are too extended to be consistent with the `inside-out' collapse model applied to a very low-mass star. In the largest cores, the spatial extent of the CS spectra with infall asymmetry is larger than the extent of the $\rm N_2H^+$ core by a factor of 2-3. All these results suggest that extended inward motions are a common feature in starless cores, and that they could represent a necessary stage in the condensation of a star-forming dense core.Comment: Two tex files for manuscript and tables, and 38 figures. To appear in ApJ

Tidal Disruption of Protoclusters in Giant Molecular Clouds

We study the collapse of protoclusters within a giant molecular cloud (GMC) to determine the conditions under which collapse is significantly disrupted. Motivated by observations of star forming regions which exhibit flattened cloud structures, this study considers collapsing protoclusters with disk geometries. The collapse of a 10^3 Msun protocluster initially a distance of 2-10 pc from a 10^3 - 10^6 Msun point mass is numerically calculated. Simulations with zero initial relative velocity between the two are completed as well as simulations with relative velocities consistent with those observed in GMCs. The results allow us to define the conditions under which it is safe to assume protocluster collapse proceeds as if in isolation. For instance, we find the collapse of a 10^3 Msun protocluster will be significantly disrupted if it is within 2-4 pc of a 10^4 Msun point mass. Thus, the collapse of a 10^3 Msun protocluster can be considered to proceed as if in isolation if it is more than ~ 4 pc away from a 10^4 Msun compact object. In addition, in no portion of the sampled parameter space does the gravitational interaction between the protocluster disk and the massive particle significantly disperse the disk into the background GMC. We discuss the distribution of clusters of young stellar objects within the Perseus and Mon R2 star forming regions, which are consistent with the results of our simulations and the limitations of our results in gas dominated regions such as the Orion cloud.Comment: 12 pages, 6 figures, Accepted for publication in Ap

High Resolution Aperture Synthesis Observations of Molecular Gas in NGC1068

We have obtained high resolution (2.9″∼260 pc) aperture synthesis imaging of NGC 1068 in the CO J = 1 → 0 line made with the Owens Valley mm Interferometer. The major features seen in CO are: (1) the inner spiral arms of molecular gas at ∼15″ radius (1.5 kpc) which originate from the ends of the central stellar bar, and (2) a compact source (∼3″) coincident with the Seyfert 2 nucleus. The components within 2 kpc of the galactic nucleus account for approximately 30% of the total molecular gas content in NGC 1068. The spiral arm CO emission is resolved into 38 discrete complexes which closely correlate with regions of strong Hα and 10 μm emission. The sizes of these structures range up to 500 pc and their masses derived from the CO line flux are 2×10^7−7×10^8M⊙. Somewhat smaller mass estimates are obtained from the virial theorem using the observed CO linewidths and sizes, suggesting that these complexes may be self-gravitating