Increased daily physical activity and fatigue symptoms in chronic fatigue syndrome

Individuals with chronic fatigue syndrome (CFS) have been shown to have reduced activity levels associated with heightened feelings of fatigue. Previous research has demonstrated that exercise training has beneficial effects on fatigue-related symptoms in individuals with CFS. PURPOSE: The aim of this study was to sustain an increase in daily physical activity in CFS patients for 4 weeks and assess the effects on fatigue, muscle pain and overall mood. METHODS: Six CFS and seven sedentary controls were studied. Daily activity was assessed by a CSA accelerometer. Following a two week baseline period, CFS subjects were asked to increase their daily physical activity by 30% over baseline by walking a prescribed amount each day for a period of four weeks. Fatigue, muscle pain and overall mood were reported daily using a 0 to 100 visual analog scale and weekly using the Profile of Mood States (Bipolar) questionnaire. RESULTS: CFS patients had significantly lower daily activity counts than controls (162.5 ± 51.7 × 10(3 )counts/day vs. 267.2 ± 79.5 × 10(3 )counts/day) during a 2-week baseline period. At baseline, the CFS patients reported significantly (P < 0.01) higher fatigue and muscle pain intensity compared to controls but the groups did not differ in overall mood. CFS subjects increased their daily activity by 28 ± 19.7% over a 4 week period. Overall mood and muscle pain worsened in the CFS patients with increased activity. CONCLUSION: CFS patients were able to increase their daily physical activity for a period of four weeks. In contrast to previous studies fatigue, muscle pain, and overall mood did not improve with increased activity. Increased activity was not presented as a treatment which may account for the differential findings between this and previous studies. The results suggest that a daily "activity limit" may exist in this population. Future studies on the impact of physical activity on the symptoms of CFS patients are needed

Modular Invariance of Finite Size Corrections and a Vortex Critical Phase

We analyze a continuous spin Gaussian model on a toroidal triangular lattice with periods $L_0$ and $L_1$ where the spins carry a representation of the fundamental group of the torus labeled by phases $u_0$ and $u_1$. We find the {\it exact finite size and lattice corrections}, to the partition function $Z$, for arbitrary mass $m$ and phases $u_i$. Summing $Z^{-1/2}$ over phases gives the corresponding result for the Ising model. The limits $m\rightarrow0$ and $u_i\rightarrow0$ do not commute. With $m=0$ the model exhibits a {\it vortex critical phase} when at least one of the $u_i$ is non-zero. In the continuum or scaling limit, for arbitrary $m$, the finite size corrections to $-\ln Z$ are {\it modular invariant} and for the critical phase are given by elliptic theta functions. In the cylinder limit $L_1\rightarrow\infty$ the ``cylinder charge'' $c(u_0,m^2L_0^2)$ is a non-monotonic function of $m$ that ranges from $2(1+6u_0(u_0-1))$ for $m=0$ to zero for $m\rightarrow\infty$.Comment: 12 pages of Plain TeX with two postscript figure insertions called torusfg1.ps and torusfg2.ps which can be obtained upon request from [email protected]

Imaging of ischemia, obstruction and infection in the abdomen

Intestinal ischemia is a serious condition that continues to be associated with mortalities in excess of 70%. Intestinal obstruction and gastrointestinal tract sepsis are common conditions, accounting for a large proportion of patients admitted to emergency departments with acute abdominal symptoms. This article discusses the imaging methods and key findings of these entities in the emergency radiology department. The article includes imaging examples, diagnostic options, protocol selections, diagnostic criteria, and differential diagnoses

Minimization of Radiation Exposure due to Computed Tomography in Inflammatory Bowel Disease

Patient awareness and concern regarding the potential health risks from ionizing radiation have peaked recently (Coakley et al., 2011) following widespread press and media coverage of the projected cancer risks from the increasing use of computed tomography (CT) (Berrington et al., 2007). The typical young and educated patient with inflammatory bowel disease (IBD) may in particular be conscious of his/her exposure to ionising radiation as a result of diagnostic imaging. Cumulative effective doses (CEDs) in patients with IBD have been reported as being high and are rising, primarily due to the more widespread and repeated use of CT (Desmond et al., 2008). Radiologists, technologists, and referring physicians have a responsibility to firstly counsel their patients accurately regarding the actual risks of ionizing radiation exposure; secondly to limit the use of those imaging modalities which involve ionising radiation to clinical situations where they are likely to change management; thirdly to ensure that a diagnostic quality imaging examination is acquired with lowest possible radiation exposure. In this paper, we synopsize available evidence related to radiation exposure and risk and we report advances in low-dose CT technology and examine the role for alternative imaging modalities such as ultrasonography or magnetic resonance imaging which avoid radiation exposure

CT densitometry as a predictor of pulmonary function in lung cancer patients.

Purpose: Preoperative pulmonary assessment is undertaken in patients with resectable lung cancer to identify those at increased risk of perioperative complications. Guidelines from the American College of Chest Physicians indicate that if the FEV1 and DLCO are ≥60% of predicted, patients are suitable for resection without further evaluation. The aim of our study is to determine if quantitative measures of lung volume and density obtained from pre-operative CT scans correlate with pulmonary function tests. This may allow us to predict pulmonary function in patients with lung cancer and identify patients who would tolerate surgical resection. Materials and Methods: Patients were identified retrospectively from the lung cancer database of a tertiary hospital. Image segmentation software was utilized to estimate total lung volume, normal lung volume (values -500 HU to -910 HU), emphysematous volume (values less than -910 HU), and mean lung density from pre-operative CT studies for each patient and these values were compared to contemporaneous pulmonary function tests. Results: A total of 77 patients were enrolled. FEV1 was found to correlate significantly with the mean lung density (r=.762, p<.001) and the volume of emphysema (r= -.678, p<.001). DLCO correlated significantly with the mean lung density (r =.648, p<.001) and the volume of emphysematous lung (r= -.535, p<.001). Conclusion: The results of this study suggest that both FEV1 and DLCO correlate significantly with volume of emphysema and mean lung density. We now plan to prospectively compare these CT parameters with measures of good and poor outcome postoperatively to identify CT measures that may predict surgical outcome preoperatively

Pain in the Past and Pleasure in the Future : The Development of Past-Future Preferences for Hedonic Goods

It seems self-evident that people prefer painful experiences to be in the past and pleasurable experiences to lie in the future. Indeed, it has been claimed that, for hedonic goods, this preference is absolute (Sullivan, 2018). Yet very little is known about the extent to which people demonstrate explicit preferences regarding the temporal location of hedonic experiences, about the developmental trajectory of such preferences, and about whether such preferences are impervious to differences in the quantity of envisaged past and future pain or pleasure. We find consistent evidence that, all else being equal, adults and children aged 7 and over prefer pleasure to lie in the future and pain in the past and believe that other people will too. They also predict that other people will be happier when pleasure is in the future rather than the past but sadder when pain is the future rather than the past. Younger children have the same temporal preferences as adults for their own painful experiences, but prefer their pleasure to lie in the past, and do not predict that others’ levels of happiness or sadness vary dependent on whether experiences lie in the past or the future. However, from the age of 7, temporal preferences were typically abandoned at the earliest opportunity when the quantity of past pain or pleasure was greater than the quantity located in the future. Past-future preferences for hedonic goods emerge early developmentally but are surprisingly flexible

Palaeontological evidence for an Oligocene divergence between Old World monkeys and apes

Apes and Old World monkeys are prominent components of modern African and Asian ecosystems, yet the earliest phases of their evolutionary history have remained largely undocumented(1). The absence of crown catarrhine fossils older than similar to 20 million years (Myr) has stood in stark contrast to molecular divergence estimates of similar to 25-30 Myr for the split between Cercopithecoidea (Old World monkeys) and Hominoidea (apes), implying long ghost lineages for both clades(2-4). Here we describe the oldest known fossil 'ape', represented by a partial mandible preserving dental features that place it with 'nyanzapithecine' stem hominoids. Additionally, we report the oldest stem member of the Old World monkey clade, represented by a lower third molar. Both specimens were recovered from a precisely dated 25.2-Myr-old stratum in the Rukwa Rift, a segment of the western branch of the East African Rift in Tanzania. These finds extend the fossil record of apes and Old World monkey swell into the Oligocene epoch of Africa, suggesting a possible link between diversification of crown catarrhines and changes in the African landscape brought about by previously unrecognized tectonic activity(5) in the East African rift system

Repositioning Antitubercular 6-Nitro-2,3-dihydroimidazo[2,1-b][1,3]oxazoles for Neglected Tropical Diseases: Structure-Activity Studies on a Preclinical Candidate for Visceral Leishmaniasis.

6-Nitro-2,3-dihydroimidazo[2,1-b][1,3]oxazole derivatives were initially studied for tuberculosis within a backup program for the clinical trial agent pretomanid (PA-824). Phenotypic screening of representative examples against kinetoplastid diseases unexpectedly led to the identification of DNDI-VL-2098 as a potential first-in-class drug candidate for visceral leishmaniasis (VL). Additional work was then conducted to delineate its essential structural features, aiming to improve solubility and safety without compromising activity against VL. While the 4-nitroimidazole portion was specifically required, several modifications to the aryloxy side chain were well-tolerated e.g., exchange of the linking oxygen for nitrogen (or piperazine), biaryl extension, and replacement of phenyl rings by pyridine. Several less lipophilic analogues displayed improved aqueous solubility, particularly at low pH, although stability toward liver microsomes was highly variable. Upon evaluation in a mouse model of acute Leishmania donovani infection, one phenylpyridine derivative (37) stood out, providing efficacy surpassing that of the original preclinical lead