Seeing double: the low-carb diet

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Assessment of vitamin E status in patients with systemic inflammatory response syndrome: plasma, plasma corrected for lipids or red blood cell measurements?

<b>Background:</b> There is some evidence that the plasma vitamin E status is perturbed as part of systemic inflammatory response and correcting this with other plasma markers may not lead to reliable results. The aim of the present study was to examine the longitudinal inter-relationships between plasma and red blood cell vitamin α-tocopherol in patients with systemic inflammatory response syndrome. <b>Methods:</b> α-tocopherol concentrations were measured, by HPLC, in plasma and red blood cells in normal subjects (n = 67) and in critically ill patients with systemic inflammatory response syndrome (n = 82) on admission and on follow-up. <b>Results:</b> Plasma α-tocopherol was significantly lower in the critically ill patients compared with the controls (all p < 0.001) with 41% of patients having concentrations below the 95% confidence interval. In contrast, when corrected for cholesterol, α-tocopherol concentrations were significantly higher in the critically ill patients compared with the control group (p < 0.001, 27% above the 95% confidence interval) and when corrected for triglycerides, α-tocopherol concentrations were significantly lower in the critically ill patients compared with the control group (p < 0.001). Red blood cell α-tocopherol corrected for haemoglobin was similar (p = 0.852) in the critically ill patients compared with control subjects. The longitudinal measurements (n = 53) gave similar results. <b>Conclusions:</b> These results indicate that there is a discrepancy between vitamin E measurements in plasma, in plasma corrected for lipids and in red blood cells. Although the value of correcting vitamin E concentrations by lipids is well established in population studies, the present study indicates that such correction is unreliable in the presence of systemic inflammatory response syndrome and that vitamin E status should be assessed using red blood cell α-tocopherol measurement

Truthful Multi-unit Procurements with Budgets

We study procurement games where each seller supplies multiple units of his item, with a cost per unit known only to him. The buyer can purchase any number of units from each seller, values different combinations of the items differently, and has a budget for his total payment. For a special class of procurement games, the {\em bounded knapsack} problem, we show that no universally truthful budget-feasible mechanism can approximate the optimal value of the buyer within $\ln n$, where $n$ is the total number of units of all items available. We then construct a polynomial-time mechanism that gives a $4(1+\ln n)$-approximation for procurement games with {\em concave additive valuations}, which include bounded knapsack as a special case. Our mechanism is thus optimal up to a constant factor. Moreover, for the bounded knapsack problem, given the well-known FPTAS, our results imply there is a provable gap between the optimization domain and the mechanism design domain. Finally, for procurement games with {\em sub-additive valuations}, we construct a universally truthful budget-feasible mechanism that gives an $O(\frac{\log^2 n}{\log \log n})$-approximation in polynomial time with a demand oracle.Comment: To appear at WINE 201

Oscillating Positive Expiratory Pressure on Respiratory Resistance in Chronic Obstructive Pulmonary Disease With a Small Amount of Secretion: A Randomized Clinical Trial

Abstract: This study aims to evaluate the acute effects of an oscillating positive expiratory pressure device (flutter) on airways resistance in patients with chronic obstructive pulmonary disease (COPD). Randomized crossover study: 15 COPD outpatients from Asthma Lab–Royal Brompton Hospital underwent spirometry, impulse oscillometry (IOS) for respiratory resistance (R) and reactance (X), and fraction exhaled nitric oxide (FeNO) measures. Thirty minutes of flutter exercises: a “flutter-sham” procedure was used as a control, and airway responses after a short-acting bronchodilator were also assessed. Respiratory system resistance (R): in COPD patients an increase in X5insp (-0.21 to -0.33 kPa/L/s) and Fres (24.95 to 26.16 Hz) occurred immediately after flutter exercises without bronchodilator. Following 20 min of rest, a decrease in the R5, [DELTA]R5, R20, X5, and Ax was observed, with R5, R20, and X5 values lower than baseline, with a moderate effect size; there were no changes in FeNO levels or spirometry. The use of flutter can decrease the respiratory system resistance and reactance and expiratory flow limitation in stable COPD patients with small amounts of secretions

Impact of proctoring on success rates for percutaneous revascularisation of coronary chronic total occlusions.

OBJECTIVE: To assess the impact of proctoring for chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in six UK centres. METHODS: We retrospectively analysed 587 CTO procedures from six UK centres and compared success rates of operators who had received proctorship with success rates of the same operators before proctorship (pre-proctored) and operators in the same institutions who had not been proctored (non-proctored). There were 232 patients in the pre-proctored/non-proctored group and 355 patients in the post-proctored group. Complexity was assessed by calculating the Japanese CTO (JCTO) score for each case. RESULTS: CTO PCI success was greater in the post-proctored compared with the pre-proctored/non-proctored group (77.5% vs 62.1%, p<0.0001). In more complex cases where JCTO≥2, the difference in success was greater (70.7% vs 49.5%, p=0.0003). After proctoring, there was an increase in CTO PCI activity in centres from 2.5% to 3.5%, p<0.0001 (as a proportion of total PCI), and the proportion of very difficult cases with JCTO score ≥3 increased from 15.3% (35/229) to 29.7% (105/354), p<0.0001. CONCLUSIONS: Proctoring resulted in an increase in procedural success for CTO PCI, an increase in complex CTO PCI and an increase in total CTO PCI activity. Proctoring may be a valuable way to improve access to CTO PCI and the likelihood of procedural success

The Traveling Salesman Problem: Low-Dimensionality Implies a Polynomial Time Approximation Scheme

The Traveling Salesman Problem (TSP) is among the most famous NP-hard optimization problems. We design for this problem a randomized polynomial-time algorithm that computes a (1+eps)-approximation to the optimal tour, for any fixed eps>0, in TSP instances that form an arbitrary metric space with bounded intrinsic dimension. The celebrated results of Arora (A-98) and Mitchell (M-99) prove that the above result holds in the special case of TSP in a fixed-dimensional Euclidean space. Thus, our algorithm demonstrates that the algorithmic tractability of metric TSP depends on the dimensionality of the space and not on its specific geometry. This result resolves a problem that has been open since the quasi-polynomial time algorithm of Talwar (T-04)

Measurement of the 58Ni(α, γ) 62Zn reaction and its astrophysical impact

Funding Details: PHY 08-22648, NSF, National Science Foundation; PHY 0969058, NSF, National Science Foundation; PHY 1102511, NSF, National Science FoundationCross section measurements of the 58Ni(α,γ)62Zn reaction were performed in the energy range Eα=5.5to9.5 MeV at the Nuclear Science Laboratory of the University of Notre Dame, using the NSCL Summing NaI(Tl) detector and the γ-summing technique. The measurements are compared to predictions in the statistical Hauser-Feshbach model of nuclear reactions using the SMARAGD code. It is found that the energy dependence of the cross section is reproduced well but the absolute value is overestimated by the prediction. This can be remedied by rescaling the α width by a factor of 0.45. Stellar reactivities were calculated with the rescaled α width and their impact on nucleosynthesis in type Ia supernovae has been studied. It is found that the resulting abundances change by up to 5% when using the new reactivities. © 2014 American Physical Society.Peer reviewe

The effect of the systemic inflammatory response on plasma vitamin 25 (OH) D concentrations adjusted for albumin

&lt;b&gt;Aim&lt;/b&gt;&lt;p&gt;&lt;/p&gt; To examine the relationship between plasma 25(OH)D, CRP and albumin concentrations in two patient cohorts.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Methods&lt;/b&gt;&lt;p&gt;&lt;/p&gt; 5327 patients referred for nutritional assessment and 117 patients with critical illness were examined. Plasma 25 (OH) D concentrations were measured using standard methods. Intra and between assay imprecision was &#60;10%.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Result&lt;/b&gt;&lt;p&gt;&lt;/p&gt; In the large cohort, plasma 25 (OH) D was significantly associated with CRP (rs = −0.113, p&#60;0.001) and albumin (rs = 0.192, p&#60;0.001). 3711 patients had CRP concentrations ≤10 mg/L; with decreasing albumin concentrations ≥35, 25–34 and &#60;25 g/l, median concentrations of 25 (OH) D were significantly lower from 35 to 28 to 14 nmol/l (p&#60;0.001). This decrease was significant when albumin concentrations were reduced between 25–34 g/L (p&#60;0.001) and when albumin &#60;25 g/L (p&#60;0.001). 1271 patients had CRP concentrations between 11–80 mg/L; with decreasing albumin concentrations ≥35, 25–34 and &#60;25 g/l, median concentrations of 25 (OH) D were significantly lower from 31 to 24 to 19 nmol/l (p&#60;0.001). This decrease was significant when albumin concentration were 25–34 g/L (p&#60;0.001) and when albumin &#60;25 g/L (p&#60;0.001). 345 patients had CRP concentrations &#62;80 mg/L; with decreasing albumin concentrations ≥35, 25–34 and &#60;25 g/l, median concentrations of 25 (OH) D were not significantly altered varying from 19 to 23 to 23 nmol/l. Similar relationships were also obtained in the cohort of patients with critical illness.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Conclusion&lt;/b&gt;&lt;p&gt;&lt;/p&gt; Plasma concentrations of 25(OH) D were independently associated with both CRP and albumin and consistent with the systemic inflammatory response as a major confounding factor in determining vitamin D status.&lt;p&gt;&lt;/p&gt

Vertex Sparsifiers: New Results from Old Techniques

Given a capacitated graph $G = (V,E)$ and a set of terminals $K \subseteq V$, how should we produce a graph $H$ only on the terminals $K$ so that every (multicommodity) flow between the terminals in $G$ could be supported in $H$ with low congestion, and vice versa? (Such a graph $H$ is called a flow-sparsifier for $G$.) What if we want $H$ to be a "simple" graph? What if we allow $H$ to be a convex combination of simple graphs? Improving on results of Moitra [FOCS 2009] and Leighton and Moitra [STOC 2010], we give efficient algorithms for constructing: (a) a flow-sparsifier $H$ that maintains congestion up to a factor of $O(\log k/\log \log k)$, where $k = |K|$, (b) a convex combination of trees over the terminals $K$ that maintains congestion up to a factor of $O(\log k)$, and (c) for a planar graph $G$, a convex combination of planar graphs that maintains congestion up to a constant factor. This requires us to give a new algorithm for the 0-extension problem, the first one in which the preimages of each terminal are connected in $G$. Moreover, this result extends to minor-closed families of graphs. Our improved bounds immediately imply improved approximation guarantees for several terminal-based cut and ordering problems.Comment: An extended abstract appears in the 13th International Workshop on Approximation Algorithms for Combinatorial Optimization Problems (APPROX), 2010. Final version to appear in SIAM J. Computin