526 research outputs found
The effect of body mass index on global brain volume in middle-aged adults: a cross sectional study
BACKGROUND: Obesity causes or exacerbates a host of medical conditions, including cardiovascular, pulmonary, and endocrine diseases. Recently obesity in elderly women was associated with greater risk of dementia, white matter ischemic changes, and greater brain atrophy. The purpose of this study was to determine whether body type affects global brain volume, a marker of atrophy, in middle-aged men and women. METHODS: T1-weighted 3D volumetric magnetic resonance imaging was used to assess global brain volume for 114 individuals 40 to 66 years of age (average = 54.2 years; standard deviation = 6.6 years; 43 men and 71 women). Total cerebrospinal fluid and brain volumes were obtained with an automated tissue segmentation algorithm. A regression model was used to determine the effect of age, body mass index (BMI), and other cardiovascular risk factors on brain volume and cognition. RESULTS: Age and BMI were each associated with decreased brain volume. BMI did not predict cognition in this sample; however elevated diastolic blood pressure was associated with poorer episodic learning performance. CONCLUSION: These findings suggest that middle-aged obese adults may already be experiencing differentially greater brain atrophy, and may potentially be at greater risk for future cognitive decline
Predictive significance of the six-minute walk distance for long-term survival in chronic hypercapnic respiratory failure
Background: The 6-min walk distance ( 6-MWD) is a global marker of functional capacity and prognosis in chronic obstructive pulmonary disease ( COPD), but less explored in other chronic respiratory diseases. Objective: To study the role of 6-MWD in chronic hypercapnic respiratory failure ( CHRF). Methods: In 424 stable patients with CHRF and non-invasive ventilation ( NIV) comprising COPD ( n = 197), restrictive diseases ( RD; n = 112) and obesity-hypoventilation- syndrome ( OHS; n = 115), the prognostic value of 6-MWD for long- term survival was assessed in relation to that of body mass index (BMI), lung function, respiratory muscle function and laboratory parameters. Results: 6-MWD was reduced in patients with COPD ( median 280 m; quartiles 204/350 m) and RD ( 290 m; 204/362 m) compared to OHS ( 360 m; 275/440 m; p <0.001 each). Overall mortality during 24.9 (13.1/40.5) months was 22.9%. In the 424 patients with CHRF, 6-MWD independently predicted mortality in addition to BMI, leukocytes and forced expiratory volume in 1 s ( p <0.05 each). In COPD, 6-MWD was strongly associated with mortality using the median {[} p <0.001, hazard ratio ( HR) = 3.75, 95% confidence interval (CI): 2.24-6.38] or quartiles as cutoff levels. In contrast, 6-MWD was only significantly associated with impaired survival in RD patients when it was reduced to 204 m or less (1st quartile; p = 0.003, HR = 3.31, 95% CI: 1.73-14.10), while in OHS 6-MWD had not any prognostic value. Conclusions: In patients with CHRF and NIV, 6-MWD was predictive for long- term survival particularly in COPD. In RD only severely reduced 6-MWD predicted mortality, while in OHS 6-MWD was relatively high and had no prognostic value. These results support a disease-specific use of 6-MWD in the routine assessment of patients with CHRF. Copyright (C) 2007 S. Karger AG, Basel
Systematic review of communication technologies to promote access and engagement of young people with diabetes into healthcare
Background: Research has investigated whether communication technologies (e.g. mobile telephony, forums,
email) can be used to transfer digital information between healthcare professionals and young people who live
with diabetes. The systematic review evaluates the effectiveness and impact of these technologies on
communication.
Methods: Nine electronic databases were searched. Technologies were described and a narrative synthesis of all
studies was undertaken.
Results: Of 20,925 publications identified, 19 met the inclusion criteria, with 18 technologies assessed. Five
categories of communication technologies were identified: video-and tele-conferencing (n = 2); mobile telephony
(n = 3); telephone support (n = 3); novel electronic communication devices for transferring clinical information (n =
10); and web-based discussion boards (n = 1). Ten studies showed a positive improvement in HbA1c following the
intervention with four studies reporting detrimental increases in HbA1c levels. In fifteen studies communication
technologies increased the frequency of contact between patient and healthcare professional. Findings were
inconsistent of an association between improvements in HbA1c and increased contact. Limited evidence was
available concerning behavioural and care coordination outcomes, although improvement in quality of life, patientcaregiver
interaction, self-care and metabolic transmission were reported for some communication technologies.
Conclusions: The breadth of study design and types of technologies reported make the magnitude of benefit and
their effects on health difficult to determine. While communication technologies may increase the frequency of
contact between patient and health care professional, it remains unclear whether this results in improved
outcomes and is often the basis of the intervention itself. Further research is needed to explore the effectiveness
and cost effectiveness of increasing the use of communication technologies between young people and
healthcare professionals
Multiple Interactions and the Structure of Beam Remnants
Recent experimental data have established some of the basic features of
multiple interactions in hadron-hadron collisions. The emphasis is therefore
now shifting, to one of exploring more detailed aspects. Starting from a brief
review of the current situation, a next-generation model is developed, wherein
a detailed account is given of correlated flavour, colour, longitudinal and
transverse momentum distributions, encompassing both the partons initiating
perturbative interactions and the partons left in the beam remnants. Some of
the main features are illustrated for the Tevatron and the LHC.Comment: 69pp, 33 figure
Dusty Planetary Systems
Extensive photometric stellar surveys show that many main sequence stars show
emission at infrared and longer wavelengths that is in excess of the stellar
photosphere; this emission is thought to arise from circumstellar dust. The
presence of dust disks is confirmed by spatially resolved imaging at infrared
to millimeter wavelengths (tracing the dust thermal emission), and at optical
to near infrared wavelengths (tracing the dust scattered light). Because the
expected lifetime of these dust particles is much shorter than the age of the
stars (>10 Myr), it is inferred that this solid material not primordial, i.e.
the remaining from the placental cloud of gas and dust where the star was born,
but instead is replenished by dust-producing planetesimals. These planetesimals
are analogous to the asteroids, comets and Kuiper Belt objects (KBOs) in our
Solar system that produce the interplanetary dust that gives rise to the
zodiacal light (tracing the inner component of the Solar system debris disk).
The presence of these "debris disks" around stars with a wide range of masses,
luminosities, and metallicities, with and without binary companions, is
evidence that planetesimal formation is a robust process that can take place
under a wide range of conditions. This chapter is divided in two parts. Part I
discusses how the study of the Solar system debris disk and the study of debris
disks around other stars can help us learn about the formation, evolution and
diversity of planetary systems by shedding light on the frequency and timing of
planetesimal formation, the location and physical properties of the
planetesimals, the presence of long-period planets, and the dynamical and
collisional evolution of the system. Part II reviews the physical processes
that affect dust particles in the gas-free environment of a debris disk and
their effect on the dust particle size and spatial distribution.Comment: 68 pages, 25 figures. To be published in "Solar and Planetary
Systems" (P. Kalas and L. French, Eds.), Volume 3 of the series "Planets,
Stars and Stellar Systems" (T.D. Oswalt, Editor-in-chief), Springer 201
Increased risk of malignancies in a population-based study of 818 soft-tissue sarcoma patients
Soft-tissue sarcomas (STS) have been associated with various rare cancer syndromes and occur at increased frequencies in survivors of childhood cancer. Also adult patients with STS have been suggested to be at an increased risk of additional malignancies. After exclusion of syndrome-associated and radiation-induced sarcomas, we studied multiple primary malignancies in a population-based cohort of 818 patients with primary STS of the extremities and the trunk wall. In total, 203 other malignancies developed in 164 (20%) patients median 10 (0–32) years before and median 4 (0–35) years after the sarcoma diagnosis. Standardised morbidity ratios (SMRs) were determined for primary malignancies following a STS. Hereby individuals who had developed a STS were identified to be at increased risk of second primary malignancies (SMR for all malignant tumours=1.3; 95% CI=1.0–1.5; P=0.02) with STS being the only specific tumour type that occurred at an increased risk (SMR=17.6; 95% CI=8.1–33.5; P<0.001). Hence, this population-based series demonstrates a high frequency of second primary tumours among STS patients and indicates a particularly increased risk of developing a new STS
Parent and child physical activity and sedentary time: Do active parents foster active children?
<p>Abstract</p> <p>Background</p> <p>Physical activity has many positive effects on children's health while TV viewing has been associated with adverse health outcomes. Many children do not meet physical activity recommendations and exceed TV viewing guidelines. Parents are likely to be an important influence on their children's behaviour. There is an absence of information about the associations between parents' and children's physical activity and TV viewing.</p> <p>Methods</p> <p>Year 6 children and their parent were recruited from 40 primary schools. Results are presented for the 340 parent-child dyads with accelerometer data that met a ≥ 3 day inclusion criteria and the 431 parent-child dyads with complete self-reported TV viewing. Over 80% of the dyads with valid TV viewing data included mothers and their child. Mean minutes of moderate to vigorous physical activity (MVPA), minutes of sedentary time per day and counts per minute were assessed by accelerometer. Self-reported hours of TV viewing were coded into 3 groups (< 2 hours per day, 2-4 hours per day and >4 hours per day. Linear and multi-nominal regression models were run by child gender to examine parent-child associations.</p> <p>Results</p> <p>In linear regression models there was an association for the overall sedentary time of girls and their parents (t = 2.04. p = .020) but there was no association between girls' and parents' physical activity. There were no associations between parents' and boys' sedentary or physical activity time. For girls, the risk of watching more than 4 hours of TV per day, (reference = 2 hours of TV per day), was 3.67 times higher if the girl's parent watched 2-4 hours of TV per day (p = 0.037). For boys, the risk of watching more than 4 hours of TV per day, was 10.47 times higher if the boy's parent watched more than 4 hours of TV per day (p = 0.038).</p> <p>Conclusions</p> <p>There are associations in the sedentary time of parents and daughters. Higher parental TV viewing was associated with an increased risk of high levels of TV viewing for both boys and girls. There were no associations between the time that parents and children spend engaged in physical activity.</p
Health-related quality of life and long-term prognosis in chronic hypercapnic respiratory failure: a prospective survival analysis
<p>Abstract</p> <p>Background</p> <p>Health-related quality of life (HRQL) is considered as an important outcome parameter in patients with chronic diseases. This study aimed to assess the role of disease-specific HRQL for long-term survival in patients of different diagnoses with chronic hypercapnic respiratory failure (CHRF).</p> <p>Methods</p> <p>In a cohort of 231 stable patients (chronic obstructive pulmonary disease (COPD), n = 98; non-COPD (obesity-hypoventilation syndrome, restrictive disorders, neuromuscular disorders), n = 133) with CHRF and current home mechanical ventilation (HMV), HRQL was assessed by the disease-specific Severe Respiratory Insufficiency (SRI) questionnaire and its prognostic value was prospectively evaluated during a follow-up of 2–4 years, using univariate and multivariate regression analysis.</p> <p>Results</p> <p>HRQL was more impaired in COPD (mean ± SD SRI-summary score (SRI-SS) 52.5 ± 15.6) than non-COPD patients (67.6 ± 16.4; p < 0.001). Overall mortality during 28.9 ± 8.8 months of follow-up was 19.1% (31.6% in COPD, 9.8% in non-COPD). To identify the overall role of SRI, we first evaluated the total study population. SRI-SS and its subdomains (except attendance symptoms and sleep), as well as body mass index (BMI), leukocyte number and spirometric indices were associated with long-term survival (p < 0.01 each). Of these, SRI-SS, leukocytes and forced expiratory volume in 1 s (FEV<sub>1</sub>) turned out to be independent predictors (p < 0.05 each). More specifically, in non-COPD patients SRI-SS and most of its subdomains, as well as leukocyte number, were related to survival (p < 0.05), whereas in patients with COPD only BMI and lung function but not SRI were predictive.</p> <p>Conclusion</p> <p>In patients with CHRF and HMV, the disease-specific SRI was an overall predictor of long-term survival in addition to established risk factors. However, the SRI predominantly beared information regarding long-term survival in non-COPD patients, while in COPD patients objective measures of the disease state were superior. This on one hand highlights the significance of HRQL in the long-term course of patients with CHRF, on the other hand it suggests that the predictive value of HRQL depends on the underlying disease.</p
Standard versus prosocial online support groups for distressed breast cancer survivors: a randomized controlled trial
<p>Abstract</p> <p>Background</p> <p>The Internet can increase access to psychosocial care for breast cancer survivors through online support groups. This study will test a novel prosocial online group that emphasizes both opportunities for getting and giving help. Based on the helper therapy principle, it is hypothesized that the addition of structured helping opportunities and coaching on how to help others online will increase the psychological benefits of a standard online group.</p> <p>Methods/Design</p> <p>A two-armed randomized controlled trial with pretest and posttest. Non-metastatic breast cancer survivors with elevated psychological distress will be randomized to either a standard facilitated online group or to a prosocial facilitated online group, which combines online exchanges of support with structured helping opportunities (blogging, breast cancer outreach) and coaching on how best to give support to others. Validated and reliable measures will be administered to women approximately one month before and after the interventions. Self-esteem, positive affect, and sense of belonging will be tested as potential mediators of the primary outcomes of depressive/anxious symptoms and sense of purpose in life.</p> <p>Discussion</p> <p>This study will test an innovative approach to maximizing the psychological benefits of cancer online support groups. The theory-based prosocial online support group intervention model is sustainable, because it can be implemented by private non-profit or other organizations, such as cancer centers, which mostly offer face-to-face support groups with limited patient reach.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT01396174">NCT01396174</a></p
Search for Gravitational Waves from Primordial Black Hole Binary Coalescences in the Galactic Halo
We use data from the second science run of the LIGO gravitational-wave
detectors to search for the gravitational waves from primordial black hole
(PBH) binary coalescence with component masses in the range 0.2--.
The analysis requires a signal to be found in the data from both LIGO
observatories, according to a set of coincidence criteria. No inspiral signals
were found. Assuming a spherical halo with core radius 5 kpc extending to 50
kpc containing non-spinning black holes with masses in the range 0.2--, we place an observational upper limit on the rate of PBH coalescence
of 63 per year per Milky Way halo (MWH) with 90% confidence.Comment: 7 pages, 4 figures, to be submitted to Phys. Rev.
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