“A Study to Find Out Normative Reference Values for 10 Meter Walk Test for Normal Healthy Individuals in India- An Observational Study”

BACKGROUND: - The 10-meter walk test (10MWT) is a simple assessment to measure locomotor capacity in clinical and research settings. Walking speed is associated with several health-related outcomes. Factors that influence walking ability can be classified into six main physiological subsystems: central nervous system, perceptual system, peripheral nervous system, muscles, bone and/or joints, and energy production and/or delivery. AIMS AND OBJECTIVE: - To find out normative value for 10-meter walk test for normal healthy Indian individuals. METHODOLOGY: - 400 subjects were taken on the basis of inclusion and exclusion criteria. Each subject was made to perform the test on a walkway of 10 meter in which the time required to cover the distance was noted. Demonstration about the test measures were done and each subject instructed to walk at a comfortable (Normal Pace) and Fast Pace (As Fast as they could safely without running) for 10 meters. The Calculation of time was done for 6 meters only. 2 meters in the beginning was considered as acceleration phase and at the ending was considered as deceleration phase and hence were not calculated. Speed was calculated from time used to cover distance. RESULT: - The mean value of gait speed with normal pace in age group 20-30 year is 2.18± 0.33 and maximum 2.80 ± 0.51, normal pace in age group 30- 40 year is 1.97 ± 0.29 march and maximum pace mean value is 2.51 ± 0.44, normal pace in age group 40- 50 year is 1.88 ± 0.31 and maximum pace mean value is 2.34 ± 0.4, normal pace in age group 50- 60 year is 1.90 ± 0.43 and maximum pace mean value is 2.38 ± 0.51, normal pace in age group more than 60 years is 1.50 ± 1.50 & with maximum pace 1.79 ± 1.79. CONCLUSION: - Present study has established normative reference value for Indian population in age group 20-60 years

Space Solar Power Aids Space Settlement

The Grand Prize for the 2011 NASA Ames Space Settlement Contest went to a team of 7 students (11-12 grades) from Punjab, India for creating the Hyperion Space Settlement. This year the contest received 355 submissions from 1078 students sponsored by 114 teachers. Entries came from 14 countries: Australia, Bulgaria, Canada, China, India, Ireland, Japan, Pakistan, Romania, Singapore, Turkey, Ukraine, United Arab Emirates, and the United States. The prize was conferred on the students during the International Space Development Conference 2011 (ISDC 2011) held in Huntsville, Alabama, USA. Advisors: The teachers of Spring Dale Senior School in Amritsar, India. Stephen Buchanan of Ohio University served as a Space Journal Liaiso

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Targeting metabolism for lupus therapy

Drugs that correct defects in T cell metabolism may prove to be promising treatments for lupus.</jats:p

Effectiveness of brief cognitive-behavioral therapy for schizophrenia delivered by mental health nurses: relapse and recovery at 24 months

Background: evidence of the efficacy of cognitive-behavioral therapy (CBT) for schizophrenia is increasing. There are very few studies of effectiveness, especially in the medium term.Objective: to evaluate the durability of the effect of brief CBT provided by mental health nurses in community-based patients with schizophrenia (diagnosed according to ICD-10 research criteria), using time to relapse as primary outcome and days hospitalized and occupational recovery as secondary outcomes at 24-month follow-up.Method: a 2:1 randomized trial, conducted from 1999 to 2003, was performed to evaluate the effects of brief CBT delivered by mental health nurses trained over 10 days with ongoing supervision compared to treatment as usual (TAU), with measurement performed by raters blind to treatment allocation.Results: 205 (79.8%) of 257 CBT patients and 125 (75.8%) of 165 TAU patients could be followed up at 24 months. Of 205 patients in the CBT group, 64 (31.2%) relapsed, versus 57 (45.6%) of 125 patients in the TAU group (p = .02). Patients rehospitalized from the CBT group spent a total of 6710 days in hospital (mean=32.7 days), while those from the TAU group were inpatients for 6114 days (mean = 48.9 days) (p &lt;.05). Twenty-one (10.2%) of 205 patients made an occupational recovery in the CBT group, and 17 (13.6%) of 125, in the TAU group (chi2 test not significant). Mean time to relapse was 356.8 days (SD = 241.9 days) for the CBT group and 296.1 days (SD = 215.7 days) for the TAU group (OR =1.592, 95% CI = 1.038 to 2.441, p =.033).Conclusion: beneficial effects on relapse and rehospitalization following brief CBT delivered by mental health nurses in community-based patients with schizophrenia are maintained at 24-month follow-up. Occupational recovery is not improved by brief CBT.<br/

Effect of endobronchial coils vs usual care on exercise tolerance in patients with severe emphysema the RENEW randomized clinical trial

Importance Preliminary clinical trials have demonstrated that endobronchial coils compress emphysematous lung tissue and may improve lung function, exercise tolerance, and symptoms in patients with emphysema and severe lung hyperinflation. Objective To determine the effectiveness and safety of endobronchial coil treatment. Design, Setting, and Participants Randomized clinical trial conducted among 315 patients with emphysema and severe air trapping recruited from 21 North American and 5 European sites from December 2012 through November 2015. Interventions Participants were randomly assigned to continue usual care alone (guideline based, including pulmonary rehabilitation and bronchodilators; n = 157) vs usual care plus bilateral coil treatment (n = 158) involving 2 sequential procedures 4 months apart in which 10 to 14 coils were bronchoscopically placed in a single lobe of each lung. Main Outcomes and Measures The primary effectiveness outcome was difference in absolute change in 6-minute-walk distance between baseline and 12 months (minimal clinically important difference [MCID], 25 m). Secondary end points included the difference between groups in 6-minute walk distance responder rate, absolute change in quality of life using the St George’s Respiratory Questionnaire (MCID, 4) and change in forced expiratory volume in the first second (FEV1; MCID, 10%). The primary safety analysis compared the proportion of participants experiencing at least 1 of 7 prespecified major complications. Results Among 315 participants (mean age, 64 years; 52% women), 90% completed the 12-month follow-up. Median change in 6-minute walk distance at 12 months was 10.3 m with coil treatment vs −7.6 m with usual care, with a between-group difference of 14.6 m (Hodges-Lehmann 97.5% CI, 0.4 m to ∞; 1-sided P = .02). Improvement of at least 25 m occurred in 40.0% of patients in the coil group vs 26.9% with usual care (odds ratio, 1.8 [97.5% CI, 1.1 to ∞]; unadjusted between-group difference, 11.8% [97.5% CI, 1.0% to ∞]; 1-sided P = .01). The between-group difference in median change in FEV1 was 7.0% (97.5% CI, 3.4% to ∞; 1-sided P < .001), and the between-group St George’s Respiratory Questionnaire score improved −8.9 points (97.5% CI, −∞ to −6.3 points; 1-sided P < .001), each favoring the coil group. Major complications (including pneumonia requiring hospitalization and other potentially life-threatening or fatal events) occurred in 34.8% of coil participants vs 19.1% of usual care (P = .002). Other serious adverse events including pneumonia (20% coil vs 4.5% usual care) and pneumothorax (9.7% vs 0.6%, respectively) occurred more frequently in the coil group. Conclusions and Relevance Among patients with emphysema and severe hyperinflation treated for 12 months, the use of endobronchial coils compared with usual care resulted in an improvement in median exercise tolerance that was modest and of uncertain clinical importance, with a higher likelihood of major complications. Further follow-up is needed to assess long-term effects on health outcomes. Trial Registration clinicaltrials.gov Identifier: NCT0160849