Impaired Glucose Metabolism among Those with and without Diagnosed Diabetes and Mortality: A Cohort Study Using Health Survey for England Data.

The extent that controlled diabetes impacts upon mortality, compared with uncontrolled diabetes, and how pre-diabetes alters mortality risk remain issues requiring clarification

A novel walkability index for London predicts walking time in adults

Objective: To develop a novel walkability index for London and test it through measurement of associations between neighbourhood walkability and walking among adults using data from the Whitehall II Study. Background: Physical activity is essential for health; walking is the easiest way to incorporate it into everyday life. Many studies have reported positive associations between neighbourhood walkability and walking but the majority have focused on cities in North America and Australasia. Urban form with respect to street connectivity, residential density and land use mix – common components of walkability indices – is likely to differ in European cities. Methods: A walkability index for the 633 spatially contiguous census area statistics wards of London was constructed, comprising three core dimensions associated with walking behaviours: residential dwelling density, street connectivity and land use mix. Walkability was expressed as quartile scores, with wards scoring 1 being in the bottom 25% in terms of walkability, and those scoring 4 in the top 25%. A neighbourhood walkability score was assigned to each London-dwelling Whitehall II Study participant (2003-04, N=3020, mean +/-SD age=61.0y +/-6.0) as the walkability score of the ward in which their residential postcode fell. Associations between neighbourhood walkability and weekly walking time were measured using multiple logistic regression. Results: After adjustment for individual level factors and area deprivation, people in the most walkable neighbourhoods were significantly more likely to spend ≥6hr/wk (Odds Ratio 1.4; 95%Confidence Interval 1.1-1.9), than those in the least walkable. Conclusions: The walkability index constructed can predict walking time in adults: living in a more walkable neighbourhood is associated with longer weekly walking time. The index may help urban planners identify and design neighbourhoods in London with characteristics that are potentially more supportive of walking and, thereby, promote public health

Development of a novel walkability index for London, United Kingdom: cross-sectional application to the Whitehall II study

BACKGROUND: Physical activity is essential for health; walking is the easiest way to incorporate activity into everyday life. Previous studies report positive associations between neighbourhood walkability and walking but most focused on cities in North America and Australasia. Urban form with respect to street connectivity, residential density and land use mix-common components of walkability indices-differs in European cities. The objective of this study was to develop a walkability index for London and test the index using walking data from the Whitehall II Study.  METHODS: A neighbourhood walkability index for London was constructed, comprising factors associated with walking behaviours: residential dwelling density, street connectivity and land use mix. Three models were produced that differed in the land uses included. Neighbourhoods were operationalised at three levels of administrative geography: (i) 21,140 output areas, (ii) 633 wards and (iii) 33 local authorities. A neighbourhood walkability score was assigned to each London-dwelling Whitehall II Study participant (2003-04, N = 3020, mean ± SD age = 61.0 years ± 6.0) based on residential postcode. The effect of changing the model specification and the units of enumeration on spatial variation in walkability was examined. RESULTS: There was a radial decay in walkability from the centre to the periphery of London. There was high inter-model correlation in walkability scores for any given neighbourhood operationalisation (0.92-0.98), and moderate-high correlation between neighbourhood operationalisations for any given model (0.39-0.70). After adjustment for individual level factors and area deprivation, individuals in the most walkable neighbourhoods operationalised as wards were more likely to walk >6 h/week (OR = 1.4; 95 % CI: 1.1-1.9) than those in the least walkable. CONCLUSIONS: Walkability was associated with walking time in adults. This walkability index could help urban planners identify and design neighbourhoods in London with characteristics more supportive of walking, thereby promoting public health

Clinical and genetic characterisation of dystrophin-deficient muscular dystrophy in a family of Miniature Poodle dogs

Four full-sibling intact male Miniature Poodles were evaluated at 4–19 months of age. One was clinically normal and three were affected. All affected dogs were reluctant to exercise and had generalised muscle atrophy, a stiff gait and a markedly elevated serum creatine kinase activity. Two affected dogs also showed poor development, learning difficulties and episodes of abnormal behaviour. In these two dogs, investigations into forebrain structural and metabolic diseases were unremarkable; electromyography demonstrated fibrillation potentials and complex repetitive discharges in the infraspinatus, supraspinatus and epaxial muscles. Histopathological, immunohistochemical and immunoblotting analyses of muscle biopsies were consistent with dystrophin-deficient muscular dystrophy. DNA samples were obtained from all four full-sibling male Poodles, a healthy female littermate and the dam, which was clinically normal. Whole genome sequencing of one affected dog revealed a >5 Mb deletion on the X chromosome, encompassing the entire DMD gene. The exact deletion breakpoints could not be experimentally ascertained, but we confirmed that this region was deleted in all affected males, but not in the unaffected dogs. Quantitative polymerase chain reaction confirmed all three affected males were hemizygous for the mutant X chromosome, while the wildtype chromosome was observed in the unaffected male littermate. The female littermate and the dam were both heterozygous for the mutant chromosome. Forty-four Miniature Poodles from the general population were screened for the mutation and were homozygous for the wildtype chromosome. The finding represents a naturally-occurring mutation causing dystrophin-deficient muscular dystrophy in the dog

Intergenerational change and familial aggregation of body mass index

The relationship between parental BMI and that of their adult offspring, when increased adiposity can become a clinical issue, is unknown. We investigated the intergenerational change in body mass index (BMI) distribution, and examined the sex-specific relationship between parental and adult offspring BMI. Intergenerational change in the distribution of adjusted BMI in 1,443 complete families (both parents and at least one offspring) with 2,286 offspring (1,263 daughters and 1,023 sons) from the west of Scotland, UK, was investigated using quantile regression. Familial correlations were estimated from linear mixed effects regression models. The distribution of BMI showed little intergenerational change in the normal range (\25 kg/m2), decreasing overweightness (25– \30 kg/m2) and increasing obesity (C30 kg/m2). Median BMI was static across generations in males and decreased in females by 0.4 (95% CI: 0.0, 0.7) kg/m2; the 95th percentileincreased by 2.2 (1.1, 3.2) kg/m2 in males and 2.7 (1.4, 3.9) kg/m2 in females. Mothers’ BMI was more strongly associated with daughters’ BMI than was fathers’ (correlation coefficient (95% CI): mothers 0.31 (0.27, 0.36), fathers 0.19 (0.14, 0.25); P = 0.001). Mothers’ and fathers’ BMI were equally correlated with sons’ BMI (correlation coefficient: mothers 0.28 (0.22, 0.33), fathers 0.27 (0.22, 0.33). The increase in BMI between generations was concentrated at the upper end of the distribution. This, alongside the strong parent-offspring correlation, suggests that the increase in BMI is disproportionally greater among offspring of heavier parents. Familial influences on BMI among middle-aged women appear significantly stronger from mothers than father

Epidemiology of lifetime fracture prevalence in England: a population study of adults aged 55 years and over

Background: Fractures remain a substantial public health problem but epidemiological studies using survey data are sparse. This study explores the association between lifetime fracture prevalence and socio-demographic factors, health behaviours and health conditions. Methods: Fracture prevalence was calculated using a combined dataset of annual, nationally representative health surveys in England (2002-2007) containing 24,725 adults aged 55 years and over. Odds of reporting any fracture was estimated separately for each gender using logistic regression. Results: Fracture prevalence was higher in men than women (49% and 40%, respectively). In men, factors having a significant independent association with fracture included being a former regular smoker [OR: 1.18 (1.06 to 1.31)], having a limiting long-standing illness [OR: 1.47 (1.31 to 1.66)] and consuming >8 units of alcohol on the heaviest drinking day in the past week [OR: 1.65 (1.37 to 1.98)]. In women, significant factors included being separated/divorced [OR: 1.30 (1.10 to 1.55)], having a GHQ-12 score of 4+ [OR: 1.59 (1.27 to 2.00)], consuming >6 units of alcohol in the past week [OR: 2.07 (1.28 to 3.35)] and being obese [OR: 1.25 (1.03 to 1.51)]. Conclusion: A range of socio-demographic, health behaviour and health conditions, known to increase the risk of chronic disease and premature death, are also associated with fracture occurrence, probably involving the aetiological pathways of poor bone health and fall-related trauma. Keywords: lifetime fracture prevalence; fracture sites; risk factors; logistic regression; respondent recal

Planning and monitoring of patients for electrical cardioversion for atrial fibrillation

This study evaluated the waiting list for elective electrical cardioversion (ECV) for persistent atrial fibrillation (AF), focusing on when and why procedures were postponed. We compared the effects of management of the waiting list conducted by physicians versus management by nurse practitioners (NPs) and we evaluated the safety of our anticoagulating policy by means of bleeding or thromboembolic complications during and after ECV. Not all patients selected for ECV receive their treatment at the first planned instance due to a variety of reasons. These reasons are still undocumented. We evaluated 250 consecutive patients with persistent AF admitted to our clinic for elective ECV. Within 5 to 6 weeks, 186 of 242 patients (77%) received ECV. The main reason for postponing an ECV was an inadequate international normalised ratio (INR); other reasons included spontaneous sinus rhythm and switch to rate control. A total of 23 of the 147 patients (16%) managed by the research physician were postponed due to an inadequate INR at admission versus 4 out of 98 patients (4%) managed by NPs (p = 0.005) An inadequate INR is the main reason for postponing an ECV. Management of ECV by NPs is safe and leads to less postponing on admission

U-dual fluxes and Generalized Geometry

We perform a systematic analysis of generic string flux compactifications, making use of Exceptional Generalized Geometry (EGG) as an organizing principle. In particular, we establish the precise map between fluxes, gaugings of maximal 4d supergravity and EGG, identifying the complete set of gaugings that admit an uplift to 10d heterotic or type IIB supegravity backgrounds. Our results reveal a rich structure, involving new deformations of 10d supergravity backgrounds, such as the RR counterparts of the $\beta$-deformation. These new deformations are expected to provide the natural extension of the $\beta$-deformation to full-fledged F-theory backgrounds. Our analysis also provides some clues on the 10d origin of some of the particularly less understood gaugings of 4d supergravity. Finally, we derive the explicit expression for the effective superpotential in arbitrary N = 1 heterotic or type IIB orientifold compactifications, for all the allowed fluxes.Comment: 58 pages, 6 table

Asymmetric Orbifolds, Non-Geometric Fluxes and Non-Commutativity in Closed String Theory

In this paper we consider a class of exactly solvable closed string flux backgrounds that exhibit non-commutativity in the closed string coordinates. They are realized in terms of freely-acting asymmetric Z_N-orbifolds, which are themselves close relatives of twisted torus fibrations with elliptic Z_N-monodromy (elliptic T-folds). We explicitly construct the modular invariant partition function of the models and derive the non-commutative algebra in the string coordinates, which is exact to all orders in {\alpha}'. Finally, we relate these asymmetric orbifold spaces to inherently stringy Scherk-Schwarz backgrounds and non-geometric fluxes.Comment: 30 page

Electroweak Baryogenesis and Dark Matter with an approximate R-symmetry

It is well known that R-symmetric models dramatically alleviate the SUSY flavor and CP problems. We study particular modifications of existing R-symmetric models which share the solution to the above problems, and have interesting consequences for electroweak baryogenesis and the Dark Matter (DM) content of the universe. In particular, we find that it is naturally possible to have a strongly first-order electroweak phase transition while simultaneously relaxing the tension with EDM experiments. The R-symmetry (and its small breaking) implies that the gauginos (and the neutralino LSP) are pseudo-Dirac fermions, which is relevant for both baryogenesis and DM. The singlet superpartner of the U(1)_Y pseudo-Dirac gaugino plays a prominent role in making the electroweak phase transition strongly first-order. The pseudo-Dirac nature of the LSP allows it to behave similarly to a Dirac particle during freeze-out, but like a Majorana particle for annihilation today and in scattering against nuclei, thus being consistent with current constraints. Assuming a standard cosmology, it is possible to simultaneously have a strongly first-order phase transition conducive to baryogenesis and have the LSP provide the full DM relic abundance, in part of the allowed parameter space. However, other possibilities for DM also exist, which are discussed. It is expected that upcoming direct DM searches as well as neutrino signals from DM annihilation in the Sun will be sensitive to this class of models. Interesting collider and Gravity-wave signals are also briefly discussed.Comment: 50 pages, 10 figure