A correlated frailty model for analysing risk factors in bilateral corneal graft rejection for Keratoconus: a Bayesian approach

There are many unknown causes that increase the rate of corneal graft rejection. In bilateral cases, some of these unknown causes are common, and some are individual factors. In this paper, we use a correlated frailty model to analyse risk factors for bilateral corneal graft in Keratoconus. Applying the piecewise constant baseline hazard model, we have performed a Bayesian analysis of the correlated frailty model using the Markov chain Monte Carlo method. The correlated frailty model and the shared frailty model are compared by deviance information criterion. The results show more accurate and better fit for the correlated frailty model. Copyright (C) 2005 John Wiley & Sons, Ltd

Locomotory Behavior of Water Striders with Amputated Legs

The stability of the body during locomotion is a fundamental requirement for walking animals. The mechanisms that coordinate leg movement patterns are even more complex at water–air interfaces. Water striders are agile creatures on the water surface, but they can be vulnerable to leg damage, which can impair their movement. One can assume the presence of certain compensatory biomechanical factors that are involved in the maintenance of postural balance lost after an amputation. Here, we studied changes in load distribution among the legs and assessed the effects of amputation on the locomotory behavior and postural defects that may increase the risk of locomotion failure. Apparently, amputees recover a stable posture by applying leg position modifications (e.g., widening the stance) and by load redistribution to the remaining legs. Water striders showed steering failure after amputation in all cases. Amputations affected locomotion by (1) altering motion features (e.g., shorter swing duration of midlegs), (2) functional constraints on legs, (3) shorter travelled distances, and (4) stronger deviations in the locomotion path. The legs functionally interact with each other, and removal of one leg has detrimental effects on the others. This research may assist the bioinspired design of aquatic robots

Patterns of load distribution among the legs in small water striders during standing and striding

Water striders (Gerris argentatus) move across the water surface by taking advantage of the surface tension, which supports their bodyweight without breaking. During locomotion, the midlegs are primarily responsible for generating thrust, whereas the other legs support the body. Although the aspects of standing and locomotion on the water surface are well understood, relatively fewer studies concerned the coordinated biomechanical movements of the legs. In order to maintain buoyancy of the body on the water surface, the leg positions must be adjusted to distribute the bodyweight appropriately. The present study investigates distribution of the bodyweight on the legs in relatively small water striders. We aimed to understand how loading on the legs changes during sculling that leads to sliding of the body on the water surface. The assistance of all legs at every moment enables the body to maintain its floating during standing and striding. Water striders can achieve a gentle striding through the midlegs driving phase in association with smooth load shifting among their legs, which are positioned in a specific configuration to support the insect on the water surface

The association between common C677T mutation in methylenetetrahydrofolate reductase gene and the risk of venous thrombosis in an Iranian population

Background: Venous thrombosis is a multicausal disease involving acquired and genetic factors. The prevalence of methylenetetrahydrofolate reductase (MTHFR) C677T genotypes and its association with venous thrombosis is not established in the Iranian population. In this study we investigated a possible association between fasting hyperhomocysteinemia and C677T mutation in the MTHFR gene with venous thrombosis. Materials and Methods: We studied 200 venous thrombotic patients and 100 healthy controls, of similar age and sex. Mutation analysis was carried out by PCR-RFLP, and the homocysteine level was measured by EIA. Results: No significant differences in the frequency of C677T genotypes were observed between patients and controls (P=0.2). The frequency of the T allele was 21 and 27.2 in controls and patients, respectively (odds ratio, 1.27; 95 CI, 0.83-1.94, P=0.15). Fasting homocysteine level was significantly higher in patients than controls (P=0.001). Conclusions: We concluded that hyperhomocysteinemia, but not MTHFR C677T mutation, is a significant risk factor for venous thrombosis in the Iranian population, and measuring the level of homocysteine is less expensive and more useful than the genetic test for the MTHFR mutation

Plasma triglyceride and high density lipoprotein cholesterol are poor surrogate markers of pro-atherogenic chylomicron remnant homeostasis in subjects with the metabolic syndrome

Background: Subjects with metabolic syndrome (MetS) exhibit impaired lipoprotein metabolism and have an increased risk of cardiovascular disease. Although the risk is attributed primarily to the risk associated with individual components, it is also likely affected by other associated metabolic defects. Remnants of postprandial lipoproteins show potent atherogenicity in cell and animal models of insulin resistance and in pre-diabetic subjects with postprandial dyslipidemia. However, few studies have considered regulation of chylomicron remnant homeostasis in MetS per se. This study measured the plasma concentration in Caucasian men and women of small dense chylomicrons following fasting and explored associations with metabolic and anthropometric measures. Methods: A total of 215 Australian Caucasian participants (me dianage62years) were investigated. Of them, 40 participants were classified as having MetS. Apolipoprotein (apo) B-48, an exclusive marker of chylomicrons, metabolic markers and anthropometric measures were determined following an overnight fast.Results: The fasting apo B-48 concentration was 40 % higher in subjects with MetS than those without MetS. In all subjects, triglyceride ( r =0.445, P < 0.0005), non-HDL cholesterol ( r =0.28, P < 0.0005) and HDL cholesterol concentration ( r = − 0.272, P < 0.0005) were weakly associated with apo B-48 concentration. In subjects with MetS, the association of apo B-48 with triglyceride and non-HDL cholesterol was enhanced, but neither were robust markers of elevated apo B-48 in MetS (r = 0.618 and r = 0.595 respectively). There was no association between apo B-48 and HDL cholesterol in subjects with MetS. Conclusion: This study demonstrates a substantial accumulation of pro-atherogenic remnants in subjects with MetS. We have shown that in a Caucasian cohort, the fasting plasma concentration of triglyceride or HDL/non-HDL cholesterol serves as poor surrogate markers of atherogenic chylomicron remnants. These findings suggest that subjects with MetS exhibit a chronic defect in chylomicron metabolism that is likely to contribute to their increased CV risk

Development and psychometric properties of a belief-based Physical Activity Questionnaire for Diabetic Patients (PAQ-DP)

<p>Abstract</p> <p>Background</p> <p>This study carried out to develop a scale for assessing diabetic patients' perceptions about physical activity and to test its psychometric properties (The Physical Activity Questionnaire for Diabetic Patients-PAQ-DP).</p> <p>Methods</p> <p>An item pool extracted from the Theory of Planned Behavior literature was generated. Then an expert panel evaluated the items by assessing content validity index and content validity ratio. Consequently exploratory factor analysis (EFA) was performed to indicate the scale constructs. In addition reliability analyses including internal consistency and test-retest analysis were carried out.</p> <p>Results</p> <p>In all a sample of 127 women with diabetes participated in the study. Twenty-two items were initially extracted from the literature. A six-factor solution (containing 19 items) emerged as a result of an exploratory factor analysis namely: instrumental attitude, subjective norm, perceived behavioral control, affective attitude, self-identity, and intention explaining 60.30% of the variance observed. Additional analyses indicated satisfactory results for internal consistency (Cronbach's alpha ranging from 0.54 to 0.8) and intraclass correlation coefficients (ranging from 0.40 to 0.92).</p> <p>Conclusions</p> <p>The Physical Activity Questionnaire for Diabetic Patients (PAQ-DP) is the first instrument that applies the Theory of Planned Behavior in its constructs. The findings indicated that the PAQ-DP is a reliable and valid measure for assessing physical activity perceptions and now is available and can be used in future studies.</p

Abdominal obesity and low physical activity are associated with insulin resistance in overweight adolescents: a cross-sectional study

ABSTRACT: Background: Previous studies have assessed the metabolic changes and lifestyles associated with overweight adolescents. However, these associations are unclear amongst overweight adolescents who have already developed insulin resistance. This study assessed the associations between insulin resistance and anthropometric, metabolic, inflammatory, food consumption, and physical activity variables amongst overweight adolescents. Methods: This cross-sectional study divided adolescents (n = 120) between 10 and 18 years old into 3 groups: an overweight group with insulin resistance (O + IR), an overweight group without insulin resistance (O-IR), and a normal-weight control group (NW). Adolescents were matched across groups based on age, sex, pubertal maturation, and socioeconomic strata. Anthropometric, biochemical, physical activity, and food consumption variables were assessed. Insulin resistance was assessed using homeostatic model assessment (HOMA Calculator Version 2.2.2 from ©Diabetes Trials Unit, University of Oxford), and overweight status was assessed using body mass index according to World Health Organization (2007) references. A chi-square test was used to compare categorical variables. ANOVAs or Kruskal-Wallis tests were used for continuous variables. Multiple linear regression models were used to calculate the probability of the occurrence of insulin resistance based on the independent variables. Results: The risk of insulin resistance amongst overweight adolescents increases significantly when they reach a waist circumference > p95 (OR = 1.9, CIs = 1.3-2.7, p = 0.013) and watch 3 or more hours/day of television (OR = 1.7, CIs = 0.98-2.8, p = 0.033). Overweight status and insulin resistance were associated with higher levels of inflammation (hsCRP ≥1 mg/L) and cardiovascular risk according to arterial indices. With each cm increase in waist circumference, the HOMA index increased by 0.082; with each metabolic equivalent (MET) unit increase in physical activity, the HOMA index decreased by 0.026. Conclusions: Sedentary behaviour and a waist circumference > p90 amongst overweight adolescents were associated with insulin resistance, lipid profile alterations, and higher inflammatory states. A screening that includes body mass index, in waist circumference, and physical activity evaluations of adolescents might enable the early detection of these alterations