Nutritional support for head-injured patients

Copyright John Wiley & Sons. This review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 2004, Issue 3. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review.’ Perel, P. , Yanagawa, T. , Bunn, F. , Roberts, I. , Wentz, R. and Pierro, A. Nutritional support for head-injured patients. Cochrane Database of Systematic Reviews 2004, Issue 3. Art. No.: CD001530. DOI: 10.1002/14651858.CD001530.pub2Background: Head injury increases the body's metabolic responses, and therefore nutritional demands. Provision of an adequate supply of nutrients is associated with improved outcome. The best route for administering nutrition (parenterally (TPN) or enterally (EN)), and the best timing of administration (for example, early versus late) of nutrients needs to be established. Objectives: To quantify the effect on mortality and morbidity of alternative strategies of providing nutritional support following head injury. Search strategy: Trials were identified by computerised searches of the Cochrane Injuries Group specialised register, Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, National Research Register, Web of Science and other electronic trials registers. Reference lists of trials and review articles were checked. The searches were last updated in July 2006. Selection criteria: Randomised controlled trials of timing or route of nutritional support following acute traumatic brain injury. Data collection and analysis: Two authors independently abstracted data and assessed trial quality. Information was collected on death, disability, and incidence of infection. If trial quality was unclear, or if there were missing outcome data, trialists were contacted in an attempt to get further information. Main results: A total of 11 trials were included. Seven trials addressed the timing of support (early versus delayed), data on mortality were obtained for all seven trials (284 participants). The relative risk (RR) for death with early nutritional support was 0.67 (95% CI 0.41 to 1.07). Data on disability were available for three trials. The RR for death or disability at the end of follow-up was 0.75 (95% CI 0.50 to 1.11). Seven trials compared parenteral versus enteral nutrition. Because early support often involves parenteral nutrition, three of the trials are also included in the previous analyses. Five trials (207 participants) reported mortality. The RR for mortality at the end of follow-up period was 0.66 (0.41 to 1.07). Two trials provided data on death and disability. The RR was 0.69 (95% Cl 0.40 to 1.19). One trial compared gastric versus jejunal enteral nutrition, there were no deaths and the RR was not estimable. Authors' conclusions: This review suggests that early feeding may be associated with a trend towards better outcomes in terms of survival and disability. Further trials are required. These trials should report not only nutritional outcomes but also the effect on death and disability.Peer reviewe

The Becklin-Neugebauer Object as a Runaway B Star, Ejected 4000 years ago from the theta^1C system

We attempt to explain the properties of the Becklin-Neugebauer (BN) object as a runaway B star, as originally proposed by Plambeck et al. (1995). This is one of the best-studied bright infrared sources, located in the Orion Nebula Cluster -- an important testing ground for massive star formation theories. From radio observations of BN's proper motion, we trace its trajectory back to Trapezium star theta^1C, the most massive (45 Msun) in the cluster and a relatively tight (17 AU) visual binary with a B star secondary. This origin would be the most recent known runaway B star ejection event, occurring only \~4000 yr ago and providing a unique test of models of ejection from multiple systems of massive stars. Although highly obscured, we can constrain BN's mass (~7 Msun) from both its bolometric luminosity and the recoil of theta^1C. Interaction of a runaway B star with dense ambient gas should produce a compact wind bow shock. We suggest that X-ray emission from this shocked gas may have been seen by Chandra: the offset from the radio position is ~300 AU in the direction of BN's motion. Given this model, we constrain the ambient density, wind mass-loss rate and wind velocity. BN made closest approach to the massive protostar, source ``I'', 500 yr ago. This may have triggered enhanced accretion and thus outflow, consistent with previous interpretations of the outflow being a recent (~10^3 yr) "explosive" event.Comment: 6 pages, accepted to ApJ Letter

Cosmological Consequences of String-forming Open Inflation Models

We present a study of open inflation cosmological scenarios in which cosmic strings form betwen the two inflationary epochs. It is shown that in these models strings are stretched outside the horizon due to the inflationary expansion but must necessarily re-enter the horizon before the epoch of equal matter and radiation densities. We determine the power spectrum of cold dark matter perturbations in these hybrid models, finding good agreement with observations for values of $\Gamma=\Omega_0h\sim0.3$ and comparable contributions from the active and passive sources to the CMB. Finally, we briefly discuss other cosmological consequences of these models.Comment: 11 LaTeX pages with 3 eps figure

A gender-sensitised weight loss and healthy living programme for overweight and obese men delivered by Scottish Premier League football clubs (FFIT): a pragmatic randomised controlled trial.

BACKGROUND: The prevalence of male obesity is increasing but few men take part in weight loss programmes. We assessed the effect of a weight loss and healthy living programme on weight loss in football (soccer) fans. METHODS: We did a two-group, pragmatic, randomised controlled trial of 747 male football fans aged 35-65 years with a body-mass index (BMI) of 28 kg/m(2) or higher from 13 Scottish professional football clubs. Participants were randomly assigned with SAS (version 9·2, block size 2-9) in a 1:1 ratio, stratified by club, to a weight loss programme delivered by community coaching staff in 12 sessions held every week. The intervention group started a weight loss programme within 3 weeks, and the comparison group were put on a 12 month waiting list. All participants received a weight management booklet. Primary outcome was mean difference in weight loss between groups at 12 months, expressed as absolute weight and a percentage of their baseline weight. Primary outcome assessment was masked. Analyses were based on intention to treat. The trial is registered with Current Controlled Trials, number ISRCTN32677491. FINDINGS: 374 men were allocated to the intervention group and 374 to the comparison group. 333 (89%) of the intervention group and 355 (95%) of the comparison group completed 12 month assessments. At 12 months the mean difference in weight loss between groups, adjusted for baseline weight and club, was 4·94 kg (95% CI 3·95-5·94) and percentage weight loss, similarly adjusted, was 4·36% (3·64-5·08), both in favour of the intervention (p<0·0001). Eight serious adverse events were reported, five in the intervention group (lost consciousness due to drugs for pre-existing angina, gallbladder removal, hospital admission with suspected heart attack, ruptured gut, and ruptured Achilles tendon) and three in the comparison group (transient ischaemic attack, and two deaths). Of these, two adverse events were reported as related to participation in the programme (gallbladder removal and ruptured Achilles tendon). INTERPRETATION: The FFIT programme can help a large proportion of men to lose a clinically important amount of weight; it offers one effective strategy to challenge male obesity. FUNDING: Scottish Government and The UK Football Pools funded delivery of the programme through a grant to the Scottish Premier League Trust. The National Institute for Health Research Public Health Research Programme funded the assessment (09/3010/06)

Evaluation of Earbud and Wristwatch Heart Rate Monitors during Aerobic and Resistance Training

International Journal of Exercise Science 12(4): 374-384, 2019. Assessment of biometrics during exercise is evolving to create devices that are “all-inclusive , in an effort to decrease the number of devices required during exercise while providing comprehensive and accurate biometric measures. The purpose of this study was to determine the accuracy of two optical heart rate monitors, the Jabra earbud and the Mio Alpha wristwatch, during aerobic and anaerobic exercise. Twenty-two recreationally active participants (25.4 ± 6.9 years, 171 ± 11 cm, 73.9 ± 3.1 kg, and 25.2 ± 9.2% body fat) completed this study. Participants completed 30 minutes of treadmill activity, 25 minutes of high-intensity interval exercise (HIT), and 40 minutes of continuous outdoor activity of their choice, walking or running. Three heart rate (HR) monitors, (Polar chest strap, Mio Alpha, Jabra earbud) were worn during all exercises, with the Polar chest strap serving as the benchmark. HR was assessed in one-second intervals. Analyses included mean bias, mean absolute percent error (MAPE), and Lin’s concordance coefficient. Overall, the Mio Alpha had a MAPE of 5.73 ± 10.19% and a moderate correlation with the benchmark, r(c) = 0.771, performing better in the treadmill and outdoor conditions. The Jabra earbud had a MAPE of 3.14 ± 6.13%, and a high correlation with the benchmark, r(c) = 0.939, performing well in all three conditions. Placing a HR monitor in an earbud is a viable option for obtaining an accurate HR assessment during different types of exercise. The accuracy of the Mio Alpha was likely affected by wrist movements during the HIT training

Inverting the Sachs-Wolfe Formula: an Inverse Problem Arising in Early-Universe Cosmology

The (ordinary) Sachs-Wolfe effect relates primordial matter perturbations to the temperature variations $\delta T/T$ in the cosmic microwave background radiation; $\delta T/T$ can be observed in all directions around us. A standard but idealised model of this effect leads to an infinite set of moment-like equations: the integral of $P(k) j_\ell^2(ky)$ with respect to k ($0<k<\infty$) is equal to a given constant, $C_\ell$, for $\ell=0,1,2,...$. Here, P is the power spectrum of the primordial density variations, $j_\ell$ is a spherical Bessel function and y is a positive constant. It is shown how to solve these equations exactly for ~$P(k)$. The same solution can be recovered, in principle, if the first ~m equations are discarded. Comparisons with classical moment problems (where $j_\ell^2(ky)$ is replaced by $k^\ell$) are made.Comment: In Press Inverse Problems 1999, 15 pages, 0 figures, Late

Observation and studies of jet quenching in PbPb collisions at √sNN = 2.76 TeV

Jet production in PbPb collisions at a nucleon-nucleon center-of-mass energy of 2.76 TeV was studied with the Compact Muon Solenoid (CMS) detector at the LHC, using a data sample corresponding to an integrated luminosity of 6.7 μb^(−1). Jets are reconstructed using the energy deposited in the CMS calorimeters and studied as a function of collision centrality. With increasing collision centrality, a striking imbalance in dijet transverse momentum is observed, consistent with jet quenching. The observed effect extends from the lower cutoff used in this study (jet pT = 120 GeV/c) up to the statistical limit of the available data sample (jet pT ≈ 210 GeV/c). Correlations of charged particle tracks with jets indicate that the momentum imbalance is accompanied by a softening of the fragmentation pattern of the second most energetic, away-side jet. The dijet momentum balance is recovered when integrating low transverse momentum particles distributed over a wide angular range relative to the direction of the away-side jet

Long-term sustainability of bio-components production

Biofuels play an increasingly important role in motor fuel market. The list of biofuels (bio-components) in accordance with EU legislations contains a number of substances not widely used in the market. Traditionally these include: fatty acid methyl esters (FAME, in the Czech Republic methyl ether of rape seed oil) and bioethanol (also ethyl terc. buthyl ether ETBE, based on bioethanol). The availability and possible utilizations of bio-component fuels in Czech Republic and Serbia are discussed. Additional attention is paid on the identification of the possibilities to improve effectiveness of rape seeds cultivation and utilization of by-products from FAME production (utilization of sew, rape-meal and glycerol) which will allow fulfilment of the sustainability criteria for the first generation biofuels. The new approaches on renewable co-processing are commented. The concept of 3E (emissions, energy demand, and economics) is introduced specifying three main attributes for effective production of FAME production in accordance with legal compliances. Bio-components price change is analyzed in comparison to the price of motor fuels, identifying possible (speculative) crude price break-even point at the level of 149-176 USD/bbl at which point bio-fuels would become economically cost effective for the use by refiners

Chemoprevention of lung cancer—from biology to clinical reality

Lung cancer is the commonest cause of cancer death in developed countries and throughout the world. Cigarette smoking is the main risk factor for lung cancer and ex-smokers today comprise ∼50% of all new lung cancer cases. Chemoprevention builds on the concepts of field of cancerization and multistep carcinogenesis and can be defined as the use of natural or chemical compounds to prevent, inhibit or reverse the process of carcinogenesis. So far, chemoprevention studies in lung cancer have failed to reduce lung cancer mortality. New developments in biotechnology have made it possible to define more accurately high-risk populations, make earlier diagnosis possible, and allow more specific targeted therapies to be developed. Both the development and validation of biomarkers, for the selection of high-risk study populations and for response evaluation in chemoprevention studies, are important for the faster turnover of studies evaluating new agents. This article reviews the current status and describes the perspectives for new approaches in the chemoprevention of lung cance

Frequentist Estimation of Cosmological Parameters from the MAXIMA-1 Cosmic Microwave Background Anisotropy Data

We use a frequentist statistical approach to set confidence intervals on the values of cosmological parameters using the MAXIMA-1 and COBE measurements of the angular power spectrum of the cosmic microwave background. We define a $\Delta \chi^{2}$ statistic, simulate the measurements of MAXIMA-1 and COBE, determine the probability distribution of the statistic, and use it and the data to set confidence intervals on several cosmological parameters. We compare the frequentist confidence intervals to Bayesian credible regions. The frequentist and Bayesian approaches give best estimates for the parameters that agree within 15%, and confidence interval-widths that agree within 30%. The results also suggest that a frequentist analysis gives slightly broader confidence intervals than a Bayesian analysis. The frequentist analysis gives values of \Omega=0.89{+0.26\atop -0.19}, \Omega_{\rm B}h^2=0.026{+0.020\atop -0.011} and n=1.02{+0.31\atop -0.10}, and the Bayesian analysis gives values of \Omega=0.98{+0.14\atop -0.19}, \Omega_{\rm B}h^2=0.0.029{+0.015\atop-0.010}, and $n=1.18{+0.10\atop -0.23}$, all at the 95% confidence level.Comment: 10 pages, 9 Postscript figures, changes made to reflect published versio