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A protocol for a randomised double-blind placebo-controlled feasibility study to determine whether the daily consumption of flavonoid-rich pure cocoa has the potential to reduce fatigue in people with relapsing and remitting multiple sclerosis (RRMS)
Background: Dietary interventions including consumption of flavonoids, plant compounds found in certain foods, may have the ability to improve fatigue. However, to date, no well-designed intervention studies assessing the role of flavonoid consumption for fatigue management in people with MS (pwMS) have been performed. The hypothesis is that the consumption of a flavonoid-rich pure cocoa beverage will reduce fatigue in pwMS. The aim of this study is to determine the feasibility and potential outcome of running a trial to evaluate this hypothesis. Methods: Using a randomised (1:1) double-blind placebo-controlled feasibility study, 40 men and women (20 in each trial arm) with a recent diagnosis (< 10 years) of relapsing and remitting MS (RRMS) and who are over 18 years of age will be recruited from neurology clinics and throughout the Thames Valley community. During a 6-week nutrition intervention period, participants will consume the cocoa beverage, high flavonoid or low flavonoid content, at breakfast daily. At baseline, demographic factors and disease-related factors will be assessed. Fatigue, activity and quality of life, in addition to other measures, will be taken at three visits (baseline, week 3 and week 6) in a university setting by a researcher blinded to group membership. Feasibility and fidelity will be assessed through recruitment and retention, adherence and a quantitative process evaluation at the end of the trial.We will describe demographic factors (age, gender, level of education) as well as disease-related factors (disease burden scores, length of time diagnosed with MS) and cognitive assessment, depression and quality of life and general physical activity in order to characterise participants and determine possible mediators to identify the processes by which the intervention may bring about change. Feasibility (recruitment, safety, feasibility of implementation of the intervention and evaluation, protocol adherence and data completion) and potential for benefit (estimates of effect size and variability) will be determined to inform future planned studies. Results will be presented using point estimates, 95% confidence intervals and p values. Primary statistical analysis will be on an intention-to-treat basis and will use the complete case data set. Discussion: We propose that a flavonoid-enriched cocoa beverage for the management of fatigue will be well received by participants. Further, if it is implemented early in the disease course of people diagnosed with RRMS, it will improve mobility and functioning by modifying fatigue. Trial registration: Registered with ISRCTN Registry. Trial registration No: ISRCTN69897291; Date April 2016
Cosmic dust grains strike again
A detailed simulation of air showers produced by dust grains has been
performed by means of the {\sc aires} Monte Carlo code with the aim of
comparing with experimental data. Our analysis indicates that extensive dust
grain air showers must yet be regarded as highly speculative but they cannot be
completely ruled out.Comment: Improved revised version with comments by an anonymous referee.
Accepted for publication in Physical review
Quality of Life and Costs in Parkinson's Disease: A Cross Sectional Study in Hungary.
BACKGROUND: Patient reported outcomes and costs of illness are useful to capture some of the multiple effects of a disease and its treatments. Our aim was to assess quality of life (QoL) and costs of Parkinson's disease (PD) in Hungary, and to analyze their associations. METHODS: A cross-sectional questionnaire survey was conducted in one neurology university clinic. Clinical characteristics, PD related resource utilizations and productivity loss in the past 12 months were recorded; the Hoehn&Yahr (HY) scale, PDQ-39 and EQ-5D questionnaires were applied. Cost calculation was performed from the societal perspective. RESULTS: 110 patients (34.5% female) were involved with mean age of 63.3 (SD = 11.3) and disease duration of 8.2 (SD = 5.8) years. PDQ-39 summary score was 48.1 (SD = 13.4). The average EQ-5D score was 0.59 (SD = 0.28), and was significantly lower than the population norm in age-groups 45-74. The correlation was significant between EQ-5D and PDQ-39 (-0.47, p = 0.000), the HY scale and EQ-5D (-0.3416, p = 0.0008) and PDQ-39 (0.3419, p = 0.0006) scores. The total mean cost was euro6030.2 (SD = 6163.0)/patient/year (direct medical 35.7%, direct non-medical 29.4%, indirect cost 34.9%). A one year increase in disease duration and 0.1 decrease of the EQ-5D utility score increase the yearly costs by 8 to 10%, and 7.8%, respectively. The effect of the PDQ-39 score on total cost was not significant. CONCLUSIONS: Disease severity and public health importance of PD are clearly demonstrated by the magnitude of QoL loss. PD-related costs are substantial, but are much lower in Hungary than in Western European countries. Disease duration and EQ-5D score are significant proxy of costs
75th Anniversary of âExistence of Electromagnetic-Hydrodynamic Wavesâ
We have recently passed the 75th anniversary of one of the most important
results in solar and space physics: Hannes Alfv\'en's discovery of Alfv\'en
waves and the Alfv\'en speed. To celebrate the anniversary, this article
recounts some major episodes in the history of MHD waves. Following an
initially cool reception, Alfv\'en's ideas were propelled into the spotlight by
Fermi's work on cosmic rays, the new mystery of coronal heating and, as
scientific perception of interplanetary space shifted dramatically and the
space race started, detection of Alfv\'en waves in the solar wind. From then
on, interest in MHD waves boomed, laying the foundations for modern remote
observations of MHD waves in the Sun, coronal seismology and some of today's
leading theories of coronal heating and solar wind acceleration. In 1970,
Alfv\'en received the Nobel Prize for his work in MHD, including these
discoveries. The article concludes with some reflection about what the history
implies about the way we do science, especially the advantages and pitfalls of
idealised mathematical models.Comment: 10 pages, accepted by Solar Physic
Ionospheric gas dynamics of satellites and diagnostic probes
The gas dynamics of interactions of a tenuous ionosphere with moving satellites and probes that have bearings on the diagnostics of the ionosphere are discussed. Emphasis is on the cases where the body is moving at mesothermal speeds, namely intermediate between the thermal speeds of ions and electrons of the ambient ionosphere. Methods of collision-free plasma kinetics with self-consistent field are used. The development of the topics for discussion starts with stationary Langmuir probe which entails the basic mechanism of body-plasma interaction that becomes further intricated as the body moves at a higher and higher speed. Applications of the theory of plasma interaction to meteors which move in the ionosphere are also presented.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/43801/1/11214_2004_Article_BF00212707.pd
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