Effects of two behavioral cardiac rehabilitation interventions on physical activity:A randomized controlled trial

Background: Standard cardiac rehabilitation (CR) is insufficient to help patients achieve an active lifestyle. The effects of two advanced and extended behavioral CR interventions on physical activity (PA) and sedentary behavior (SB) were assessed.Methods: In total, 731 patients with ACS were randomized to 1) 3 months of standard CR (CR-only); 2) 3 months of standard CR with three pedometer-based, face-to-face PA group counseling sessions followed by 9 months of after care with three general lifestyle, face-to-face group counseling sessions (CR+F); or 3) 3 months of standard CR, followed by 9 months of aftercare with five to six general lifestyle, telephonic counseling sessions (CR + T). An accelerometer recorded PA and SB at randomization, 3 months, 12 months, and 18 months.Results: The CR+ F group did not improve their moderate-to-vigorous intensity PA (MVPA) or SB time compared to CR-only (between-group difference= 0.24% MVPA, P= 0.349; and 0.39% SB, P= 0.529). However, step count (between-group difference = 513 steps/day, P = 0.021) and time in prolonged MVPA (OR = 2.14, P= 0.054) improved at 3 months as compared to CR-only. The improvement in prolonged MVPA was maintained at 18 months (OR = 1.91, P = 0.033). The CR + T group did not improve PA or SB compared to CR-only.Conclusions: Adding three pedometer-based, face-to-face group PA counseling sessions to standard CR increased daily step count and time in prolonged MVPA. The latter persisted at 18 months. A telephonic after-care program did not improve PA or SB. Although after-care should be optimized to improve long-term adherence, face-to-face group counseling with objective PA feedback should be added to standard CR. (C) 2017 Elsevier B.V. All rights reserved

Patients' preferences for secondary prevention following a coronary event

Objective:Despite clear evidence on the effectiveness of secondary prevention, patients with coronary artery disease frequently fail to reach guideline-based risk factor targets. Integrating patients’ preferences into treatment decisions has been recommended to reduce this gap. However, this requires knowledge about patient treatment preferences. Therefore, through a survey study, we aimed to explore which risk factors patients self-perceived, prioritised for improvement, and needed support with after a recent hospitalisation for coronary heart disease. Methods: A digital questionnaire was presented to patients &gt; 18 years recently discharged (≤3 months) from an acute coronary care unit in the Netherlands (Europe). Patients could select from eight cardiovascular risk factors that they (1) self-perceived, (2) prioritised for improvement, and (3) needed support to improve. Patients’ perceived risk factors were compared to those documented in the medical records. Results: Respondents (N = 254, 26 % women), mean age 64 (SD 10) years, identified ‘physical inactivity’ more frequently than their medical records (140 patients vs. 91 records, p &lt; 0.001), while three other risk factors were reported with equal and four with lower frequency. ‘Physical inactivity’, ‘overweight’ and ‘stress’ were most frequently prioritised for improvement (82 %, 88 % and 78 %) and professional support (64 %, 50 % and 58 %), with 87 % preferring lifestyle optimisation if this would reduce drug use. Conclusions: Patients with a recent coronary event show significant disparities in identifying risk factors compared to their medical records. They tend to prefer improving lifestyle- over drug-modifiable risk factors, particularly physical inactivity, overweight and stress, and indicate the need for support in improving these factors.</p

Downwearing rates on shore platforms of different calcareous lithotypes

Vertical lowering (downwearing) of shore platform surfaces is a very important mechanism in their morphological evolution albeit much remains incompletely understood. The efficacy of mechanical and chemical weathering acting on a given substrate, together with erosional processes, influences downwearing rates. In order to determine the relationship between lithotypes and downwearing rates, data collected from a Transverse Micro-erosion Meter were obtained for shore platforms of three different calcareous lithotypes (biocalcarenite, calcarenite and carbonated siltstone) along the central Algarve coast (Southern Portugal). Downwearing rates ranged between 0.096 mm year−1 and 1.676 mm year−1 in biocalcarenite and weakly cemented calcarenite, respectively. In addition, physical properties of the rocks comprising the platforms were measured, including uniaxial compressive strength (as determined by the Point Load Test), porosity, and calcium carbonate content. The results show that downwearing depends primarily on the intrinsic properties of the substrate. Porosity, in particular, acts in two ways: (i) it tends to weaken the substrate; and, (ii) it controls the downward extent of the water percolation and therefore the depth of the weathering mantle subject to erosion by waves and currents.Portuguese Foundation for Science and Technology (FCT) through Research Projects PTDC/CTEGEX/70448/2006 (BISHOP) and PTDC/CTE-GIX/111230/2009 (EROS)

Morphological features and processes in the central Algarve rocky coast (South Portugal)

Morphological features along the Algarve rocky coast, South Portugal, are identified and described, with an emphasis on shore platforms and notches. The contributions of processes, such as wave attack, chemical weathering and bioerosion, to sculpting the shore platforms are discussed. The preferential localization of shore platforms on sites exposed to waves, and the lack of significant chemical weathering, point to wave erosion as the first-order factor in platform formation, whilst bioerosion/bioprotection, lithology and geological structure determine platform morphological variations. In addition, platforms above the present intertidal zone appear to have a polygenetic evolution, being inherited from former sea-level highstands and currently undergoing chemical weathering. The occurrence of notch features is independent of the degree of exposure to waves, but they mostly occur where the substratum is sand. Hydrostatic pressure appears to be an important factor in the formation of marine caves in the more sheltered sites.Fundação para a Ciência e a Tecnologia. COCHAL Project (POCTI/34162/CTA/00

Disturbance of deep-sea environments induced by the M9.0 Tohoku Earthquake

The impacts of the M9.0 Tohoku Earthquake on deep-sea environment were investigated 36 and 98 days after the event. The light transmission anomaly in the deep-sea water after 36 days became atypically greater (∼35%) and more extensive (thickness ∼1500 m) near the trench axis owing to the turbulent diffusion of fresh seafloor sediment, coordinated with potential seafloor displacement. In addition to the chemical influx associated with sediment diffusion, an influx of 13C-enriched methane from the deep sub-seafloor reservoirs was estimated. This isotopically unusual methane influx was possibly triggered by the earthquake and its aftershocks that subsequently induced changes in the sub-seafloor hydrogeologic structures. The whole prokaryotic biomass and the development of specific phylotypes in the deep-sea microbial communities could rise and fall at 36 and 98 days, respectively, after the event. We may capture the snap shots of post-earthquake disturbance in deep-sea chemistry and microbial community responses

Heart failure and promotion of physical activity before and after cardiac rehabilitation (HF-aPProACH):a study protocol

Abstract Aims Lifestyle changes, such as increasing physical activity (PA), are a cornerstone of treatment of patients with chronic heart failure (HF). However, improving PA in HF patients is challenging, and low participation rates for cardiac rehabilitation (CR) as well as relapse to low PA levels after CR are major issues. We designed a randomized controlled trial to investigate if PA monitoring with motivational feedback before and after centre‐based CR in HF patients with reduced ejection fraction (HFrEF) will lead to a clinically meaningful increase in physical fitness. Methods and results A randomized controlled trial will be conducted in a sample of 180 HFrEF patients (New York Heart Association Class II/III) who are referred to 12‐week standard CR. Patients will be randomized (2:1) to (1) standard of care (SoC) plus wearing a PA monitoring device (Fitbit Charge 3) with personalized step goals, feedback and motivation or (2) SoC only. The intervention lasts ±7 months: 4–5 weeks before CR, 12 weeks during CR and 12 weeks after CR. Measurements will take place at three time points. The primary endpoint is the change in the distance in 6‐min walking test (6MWT) over the entire study period. Other endpoints include step count, grip strength, quality of life and all‐cause mortality or hospitalization. Conclusions HF‐aPProACH will provide novel information on the effectiveness of remote PA stimulation and feedback before, during and after standard CR using a commercially available device to improve physical fitness in HFrEF patients

Overexpression of the p53-inducible brain-specific angiogenesis inhibitor 1 suppresses efficiently tumour angiogenesis

The brain-specific angiogenesis inhibitor 1 gene has been isolated in an attempt to find fragments with p53 “functional” binding sites. As reported herein and by others, brain-specific angiogenesis inhibitor 1 expression is present in some normal tissues, but is reduced or lost in tumour tissues. Such data and its particular structure prompted the hypothesis that brain-specific angiogenesis inhibitor 1 may act as a mediator in the local angiogenesis balance. We herein demonstrate that brain-specific angiogenesis inhibitor 1 over-expression suppresses tumour angiogenesis, delaying significantly the human tumour growth in immunodeficient mice. The inhibitory effect of brain-specific angiogenesis inhibitor 1 was documented using our intravital microscopy system, strongly implicating brain-specific angiogenesis inhibitor 1 as a mediator in the control of tumour angiogenesis. In contrast, in vitro tumour cell proliferation was not inhibited by brain-specific angiogenesis inhibitor 1 transfection, whereas some level of cytotoxicity was assessed for endothelial cells. Immunohistochemical analysis of tumour samples confirmed a reduction in the microvessel density index in brain-specific angiogenesis inhibitor 1-overexpressing tumours. At messenger level, moderate changes could be detected, involving the down-regulation of vascular endothelial growth factor and collagenase-1 expression. Furthermore, brain-specific angiogenesis inhibitor 1 expression that was lost in a selection of human cancer cell lines could be restored by wild-type p53 adenoviral transfection. Brain-specific angiogenesis inhibitor 1 should be considered for gene therapy and development of efficient drugs based on endogenous antiangiogenic molecules

A global classification of coastal flood hazard climates associated with large-scale oceanographic forcing

Coastal communities throughout the world are exposed to numerous and increasing threats, such as coastal flooding and erosion, saltwater intrusion and wetland degradation. Here, we present the first global-scale analysis of the main drivers of coastal flooding due to large-scale oceanographic factors. Given the large dimensionality of the problem (e.g. spatiotemporal variability in flood magnitude and the relative influence of waves, tides and surge levels), we have performed a computer-based classification to identify geographical areas with homogeneous climates. Results show that 75% of coastal regions around the globe have the potential for very large flooding events with low probabilities (unbounded tails), 82% are tide-dominated, and almost 49% are highly susceptible to increases in flooding frequency due to sea-level rise.A.R., F.J.M. and P.C. acknowledge the support of the Spanish ‘Ministerio de Economia y Competitividad’ under Grants BIA2014-59643-R and BIA2015-70644-R. This work was critically supported by the US Geological Survey under Grant/Cooperative Agreement G15AC00426 and from the US DOD Strategic Environmental Research and Development Program (SERDP Project RC-2644) through the NOAA National Centers for Environmental Information (NCEI). Dynamic atmospheric corrections (storm surge) are produced by CLS Space Oceanography Division using the Mog2D model from Legos and distributed by Aviso, with support from CNES (http://www.aviso.altimetry.fr/). Marine data from global reanalysis are provided by IHCantabria and are available for research purposes upon request at [email protected]

Buffer layer-assisted growth of Ge nanoclusters on Si

In the buffer layer-assisted growth method, a condensed inert gas layer of xenon, with low-surface free energy, is used as a buffer to prevent direct interactions of deposited atoms with substrates. Because of␣an unusually wide applicability, the buffer layer-assisted growth method has provided a unique avenue for creation of nanostructures that are otherwise impossible to grow, and thus offered unprecedented opportunities for fundamental and applied research in nanoscale science and technology. In this article, we review recent progress in the application of the buffer layer-assisted growth method to the fabrication of Ge nanoclusters on Si substrates. In particular, we emphasize the novel configurations of the obtained Ge nanoclusters, which are characterized by the absence of a wetting layer, quasi-zero dimensionality with tunable sizes, and high cluster density in comparison with Ge nanoclusters that are formed with standard Stranski-Krastanov growth methods. The optical emission behaviors are discussed in correlation with the morphological properties