158 research outputs found
Census 2000 Demographic Profile Report of the Older Adult Population in Cuyahoga, Lake, Geauga, Lorain and Medina Counties
Challenges of a community based pragmatic, randomised controlled trial of weight loss maintenance
Background
Randomised controlled trials (RCTs) have a reputation for being inherently difficult to deliver as planned and often face unforeseen challenges and delays, particularly in relation to organisational and governance difficulties, participant interest, constraints due to allocation of costs, local investigator interest and lengthy bureaucracy. Recruitment is often difficult and the challenges faced often impact on the cost and delivery of a successful trial within the funded period. This paper reflects upon the challenges faced in delivering a pragmatic RCT of weight loss maintenance in a community setting and suggests some potential solutions.
Methods
The weight loss maintenance in adults trial aimed to evaluate the impact of a 12 month, individually tailored weight maintenance intervention on BMI 3 years from randomisation. Participants were recruited primarily from participant identification centres (PICs)—GP surgeries, exercise on referral schemes and slimming world. The intervention was delivered in community settings. A recruitment strategy implementation plan was drafted to address and monitor poor recruitment.
Results
Delays in opening and recruitment were experienced early on. Some were beyond the control of the study team such as; disagreement over allocation of national health service costs and PIC classification as well as difficulties in securing support from research networks. That the intervention was delivered in community settings was often at the root of these issues. Key items to address at the design stage of future trials include feasibility of eligibility criteria. The most effective element of the recruitment implementation plan was to refocus sources of recruitment and target only those who could fulfil the eligibility criteria immediately.
Conclusions
Learnings from this trial should be kept in mind by those designing similar studies in the future. Considering potential governance, cost and research network support implications at the design stage of pragmatic trials of any community-based complex intervention is paramount. The appropriateness and viability of inclusion criteria also require careful consideration as does use of a targeted advertising strategy
A Chandra Study of Temperature Substructures in Intermediate-Redshift Galaxy Clusters
By analyzing the gas temperature maps created from the Chandra archive data,
we reveal the prevailing existence of temperature substructures on ~100 kpc
scales in the central regions of nine intermediate-redshift (z~0.1) galaxy
clusters, which resemble those found in the Virgo and Coma Clusters. Each
substructure contains a clump of hot plasma whose temperature is about 2-3 keV
higher than the environment, corresponding to an excess thermal energy of
~1E58-1E60 erg per clump. Since if there were no significant non-gravitational
heating sources, these substructures would have perished in 1E8-1E9 yrs due to
thermal conduction and turbulent flows, whose velocity is found to range from
about 200 to 400 km/s, we conclude that the substructures cannot be created and
sustained by inhomogeneous radiative cooling. We also eliminate the
possibilities that the temperature substructures are caused by supernova
explosions, or by the non-thermal X-ray emission due to the
inverse-Comptonization of the CMB photons. By calculating the rising time of
AGN-induced buoyant bubbles, we speculate that the intermittent AGN outbursts
(~ 1E60 erg per burst) may have played a crucial role in the forming of the
high temperature substructures. Our results are supported by recent study of
McNamara & Nulsen (2007), posing a tight observational constraint on future
theoretical and numerical studies.Comment: 31 pages, 7 figures, ApJ accepte
Electronic Contract Administration – Legal and Security Issues Research Report
This Report is a deliverable for the CRC for Construction Innovation research project 2005-025-A Electronic Contract Administration – Legal and Security Issues. It considers the security and legal risks that result from the increasing adoption of information and communication technologies (ICT) in the construction industry for e-contracting purposes and makes recommendations to minimise those risks
Distribution of sialic acids on mucins and gels: a defense mechanism
Moist mucosal epithelial interfaces that are exposed to external environments are dominated by sugar epitopes, some of which (e.g., sialic acids) are involved in host defense. In this study, we determined the abundance and distribution of two sialic acids to assess differences in their availability to an exogenous probe in isolated mucins and mucous gels. We used atomic force microscopy to obtain force maps of human preocular mucous and purified ocular mucins by probing and locating the interactions between tip-tethered lectins Maackia amurensis and Sambucus nigra and their respective receptors, α-2,3 and α-2,6 N-acetylneuraminic (sialic) acids. The rupture force distributions were not affected by neighboring sugar-bearing molecules. Energy contours for both lectin-sugar bonds were fitted to a two-barrier model, suggesting a conformational change before dissociation. In contrast to data from purified mucin molecules, the preocular gels presented numerous large clusters (19,000 ± 4000 nm2) of α-2,6 sialic acids, but very few small clusters (2000 ± 500 nm2) of α-2,3 epitopes. This indicates that mucins, which are rich in α-2,3 sialic acids, are only partially exposed at the surface of the mucous gel. Microorganisms that recognize α-2,3 sialic acids will encounter only isolated ligands, and the adhesion of other microorganisms will be enhanced by large islands of neighboring α-2,6 sialic acids. We have unveiled an additional level of mucosal surface heterogeneity, specifically in the distribution of pro- and antiadhesive sialic acids that protect underlying epithelia from viruses and bacteria
Metal transport by gas sloshing in M87
We present the results of an XMM-Newton mosaic covering the central ~200 kpc
of the nearby Virgo cluster. We focus on a strong surface brightness
discontinuity in the outskirts of the brightest cluster galaxy, M87. Using both
XMM-Newton and Suzaku, we derive accurate temperature and metallicity profiles
across this feature and show that it is a cold front probably due to sloshing
of the Virgo ICM. It is also associated with a discontinuity in the chemical
composition. The gas in the inner, bright region of the front is ~40% more
abundant in Fe than the gas outside the front, suggesting the important role of
sloshing in transporting metals through the ICM. For the first time, we provide
a quantitative estimate of the mass of Fe transported by a cold front. This
amounts to ~6% of the total Fe mass within the radial range affected by
sloshing, significantly more than the amount of metals transported by the AGN
in the same cluster core. The very low Fe abundance of only ~0.2 solar
immediately outside the cold front at a radius of 90 kpc suggests we are
witnessing first-hand the transport of higher metallicity gas into a pristine
region, whose abundance is typical of the cluster outskirts. The Mg/Fe and O/Fe
abundance ratios remain approximately constant over the entire radial range
between the centre of M87 and the faint side of the cold front, which requires
the presence of a centrally peaked distribution not only for Fe but also for
core-collapse type supernova products. This peak may stem from the star
formation triggered as the BCG assembled during the protocluster phase.Comment: accepted for publication in MNRA
Inhaled hypertonic saline in infants and toddlers with cystic fibrosis: short-term tolerability, adherence, and safety
Inhaled hypertonic saline (HS) is an attractive agent for chronic maintenance therapy in infants and toddlers with cystic fibrosis (CF) because it improves defective mucociliary clearance. Prior to undertaking a clinical trial of HS efficacy in young children with CF, tolerability, adherence and safety must be established
Las distintas movilidades de las comunidades en las islas del PacĂfico
Los tipos de movilidad en las islas del PacĂfico son varios y distintos. Los estudios de caso en la regiĂłn nos permiten ver cuáles son las acciones y las voluntades de las personas, los hogares y las comunidades a la luz de una vulnerabilidad por cuestiones climáticas en rápido aumento
Inositol polyphosphate derivative inhibits Na + transport and improves fluid dynamics in cystic fibrosis airway epithelia
Amiloride-sensitive, epithelial Na+ channel (ENaC)-mediated, active absorption of Na+ is elevated in the airway epithelium of cystic fibrosis (CF) patients, resulting in excess fluid removal from the airway lumen. This excess fluid/volume absorption corresponds to CF transmembrane regulator-linked defects in ENaC regulation, resulting in the reduced mucociliary clearance found in CF airways. Herein we show that INO-4995, a synthetic analog of the intracellular signaling molecule, D-myo-inositol 3,4,5,6-tetrakisphosphate, inhibits Na+ and fluid absorption across CF airway epithelia, thus alleviating this critical pathology. This conclusion was based on electrophysiological studies, fluid absorption, and 22Na+ flux measurements in CF airway epithelia, contrasted with normal epithelia, and on electrophysiological studies in Madin-Darby canine kidney cells and 3T3 cells overexpressing ENaC. The effects of INO-4995 were long-lasting, dose-dependent, and more pronounced in epithelia from CF patients vs. controls. These findings support preclinical development of INO-4995 for CF treatment and demonstrate for the first time the therapeutic potential of inositol polyphosphate derivatives
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