Comparative effectiveness trial comparing MyPlate to calorie counting for mostly low-income Latino primary care patients of a federally qualified community health center: study design, baseline characteristics.

BackgroundPrimary care-based behavior change obesity treatment has long featured the Calorie restriction (CC), portion control approach. By contrast, the MyPlate-based obesity treatment approach encourages eating more high-satiety/high-satiation foods and requires no calorie-counting. This report describes study methods of a comparative effectiveness trial of CC versus MyPlate. It also describes baseline findings involving demographic characteristics and their associations with primary outcome measures and covariates, including satiety/satiation, dietary quality and acculturation.MethodsA comparative effectiveness trial was designed to compare the CC approach (n = 130) versus a MyPlate-based approach (n = 131) to treating patient overweight. Intervenors were trained community health workers. The 11 intervention sessions included two in-home health education sessions, two group education sessions, and seven telephone coaching sessions. Questionnaire and anthropometric assessments occurred at baseline, 6- and 12 months; food frequency questionnaires were administered at baseline and 12 months. Participants were overweight adult primary care patients of a federally qualified health center in Long Beach, California. Two measures of satiety/satiation and one measure of post-meal hunger comprised the primary outcome measures. Secondary outcomes included weight, waist circumference, blood pressure, dietary quality, sugary beverage intake, water intake, fruit and vegetable fiber intake, mental health and health-related quality of life. Covariates included age, gender, nativity status (U.S.-born, not U.S.-born), race/ethnicity, education, and acculturation.AnalysisBaseline characteristics were compared using chi square tests. Associations between covariates and outcome measures were evaluated using multiple regression and logistic regression.ResultsTwo thousand eighty-six adult patients were screened, yielding 261 enrollees who were 86% Latino, 8% African American, 4% White and 2% Other. Women predominated (95%). Mean age was 42 years. Most (82%) were foreign-born; 74% chose the Spanish language option. Mean BMI was 33.3 kg/m2; mean weight was 82 kg; mean waist circumference was 102 cm. Mean blood pressure was 122/77 mm. Study arms on key baseline measures did not differ except on dietary quality and sugary beverage intake. Nativity status was significantly associated with dietary quality.ConclusionsThe two treatment arms were well-balanced demographically at baseline. Nativity status is inversely related to dietary quality.Trial registrationNCT02514889 , posted on 8/4/2015

The Mind, the Brain, and the Law

In this chapter, we explore the potential influence that advances in neuroscience may have on legal decision makers and present the findings from some recent studies that probe folk intuitions concerning the relationships among neuroscience, agency, responsibility, and mental illness. We first familiarize the reader with some of the early research in experimental philosophy on people\u27s intuitions about agency and responsibility. Then, we focus on a more specific issue—namely, whether people respond to explanations of human behavior framed in neuroscientific terms differently than they respond to explanations framed in more traditional folk psychological terms. Next, we discuss some new findings which suggest that explanations of criminal behavior that are couched in neural terms appear to make people less punitive than explanations couched in mental terms, especially in the context of mental illness. Finally, we offer what we take to be the best explanation of these differences in people\u27s intuitions—namely, when people are presented with neural explanations of human behavior, they tend to think that the agent\u27s “deep self” (the values and beliefs the agent identifies with) is somehow left out of the causal loop or bypassed, which in turn mitigates the agent\u27s responsibility

Impact of Baseline Magnetic Resonance Imaging on Neurologic, Functional, and Safety Outcomes in Patients With Acute Traumatic Spinal Cord Injury

Study Design: Systematic review. Objective: To perform a systematic review to evaluate the utility of magnetic resonance imaging (MRI) in patients with acute spinal cord injury (SCI). Methods: An electronic search of Medline, EMBASE, the Cochrane Collaboration Library, and Google Scholar was conducted for literature published through May 12, 2015, to answer key questions associated with the use of MRI in patients with acute SCI. Results: The literature search yielded 796 potentially relevant citations, 8 of which were included in this review. One study used MRI in a protocol to decide on early surgical decompression. The MRI-protocol group showed improved outcomes; however, the quality of evidence was deemed very low due to selection bias. Seven studies reported MRI predictors of neurologic or functional outcomes. There was moderate-quality evidence that longer intramedullary hemorrhage (2 studies) and low-quality evidence that smaller spinal canal diameter at the location of maximal spinal cord compression and the presence of cord swelling are associated with poor neurologic recovery. There was moderate-quality evidence that clinical outcomes are not predicted by SCI lesion length and the presence of cord edema. Conclusions: Certain MRI characteristics appear to be predictive of outcomes in acute SCI, including length of intramedullary hemorrhage (moderate-quality evidence), canal diameter at maximal spinal cord compression (low-quality evidence), and spinal cord swelling (low-quality evidence). Other imaging features were either inconsistently (presence of hemorrhage, maximal canal compromise, and edema length) or not associated with outcomes. The paucity of literature highlights the need for well-designed prospective studies. © 2017, © The Author(s) 2017

Transformational Leadership, Achievement Motivation, and Perceived Stress in Basic Military Training: A Longitudinal Study of Swiss Armed Forces

In Switzerland, military service is a civic obligation for all adult male citizens, and thus, leadership style can be particularly challenging. The present study investigated the impact of superiors’ leadership styles on recruits’ achievement motivation, organizational citizenship behavior (OCB), and perceived stress during their Basic Military Training (BMT). To this end, a total of 525 male recruits (mean age: 20.3 years) recruits were assessed both cross-sectionally and longitudinally. At the start of BMT (baseline), at week 7, and at week 11, participants completed a series of selfrating questionnaires covering demographic information, achievement motivation, organizational citizenship behavior (OCB), perceived stress, and their superiors’ leadership styles (transformational, transactional und laissez-faire). Longitudinally, scores for achievement motivation and OCB showed no significant difference between baseline and the 11th week. In a group comparison, the group experiencing higher transformational leadership (from week 7 to week 11) had the highest scores for achievement motivation and OCB, and the lowest scores for perceived stress, all at week 11. Exploratively, achievement motivation and OCB at baseline were associated with transformational leadership and transactional leadership at week 7 and week 11. Perceived stress at baseline correlated only with transformational leadership but not with transactional leadership, both at week 7 and week 11. Transformational leadership style fostered achievement motivation and OCB in Swiss military recruits and protected them from stress, both cross-sectionally and longitudinally.ISSN:2071-105

Characterization of oil sands naphthenic acids by negative-ion electrospray ionization mass spectrometry : influence of acidic versus basic transfer solvent

Considerable effort and progress has been made over the past decade with respect to development of analytical tools for the determination of naphthenic acids and related components in environmental samples. However, experimental variables that influence the analytical results have not been fully explored. The relative contributions of Ox classes are of particular interest in data obtained using negative-ion electrospray ionization mass spectrometry. Using two types of ultrahigh resolution mass spectrometers (Orbitrap and FT-ICR), the apparent pH of the transfer solvent was observed to have a significant impact upon compound class distributions. A basic transfer solvent favored the detection of Ox species of lower oxygen content, while acidic pH favored the preferential observation of organic compounds with higher oxygen contents. These observed trends were independent of the instrument type. In addition, when using an acidic transfer solvent, the overall observed response was reduced by a factor of ∼20. Thus, the apparent pH of the transfer solvent has critical influence upon detection and upon the profile of different components observed within a complex mixture. In turn, this significantly impacts oil sands environmental monitoring for toxicity, forensic interpretation, and quantitation; when comparing data sets from different laboratories, these findings should therefore be taken into account

PERBANDINGAN TEPUNG JAGUNG NIKSTAMAL DENGAN JENIS TEPUNG (TEPUNG TAPIOKA, TEPUNG MOCAF, TEPUNG UBI JALAR) DAN LAMA PEMANGGANGAN TERHADAP KARAKTERISTIK FLAKES

Jagung (Zea mays L.) merupakan salah satu tanaman pangan dunia yang penting selain padi dan gandum, tetapi jagung mudah rusak, sehingga perlu diolah menjadi bahan yang awet, mudah disimpan dan penggunaannya instan, salah satu cara agar jagung menjadi awet dan tahan lama dengan dibuat menjadi tepung jagung. Tepung jagung dapat dilakukan modifikasi dengan proses nikstamalisasi. Nikstamalisasi merupakan proses tradisional Meksiko yang terdiri dari pemasakan dan perendaman dalam larutan alkali, yaitu larutan kapur (Ca(OH)2) atau kalsium hidroksida. Tujuan dari penelitian ini adalah untuk menentukan flakes terpilih yang berbahan baku tepung jagung nikstamal dengan jenis tepung terpilih (tepung tapioka, tepung mocaf, tepung ubi jalar) serta lama pemanggangan terpilih. Metode penelitian yang dilakukan terdiri dari penelitian pendahuluan dan penelitian utama. Penelitian pendahuluan dilakukan untuk mengetahui kadar air, kadar pati dan kadar serat kasar pada tepung yang digunakan. Penelitian utama dilakukan untuk menentukan perbandingan tepung dan lama pemanggangan yang tepat. Rancangan percobaan yang digunakan dalam penelitian adalah Rancangan Acak Kelompok (RAK) dengan pola faktorial 3x3 dengan jumlah ulangan sebanyak 3 kali dan rancangan perlakuan terdiri dari 27 perlakuan. Variabel respon pada penelitian ini adalah respon kimia meliputi analisis kadar air, kadar pati, kadar serat kasar serta respon organoleptik. Hasil dari penelitian pendahuluan diperoleh bahwa tepung jagung nikstamal memiliki kadar air 8,50%, kadar pati 60,81%, kadar serat kasar 1,25%. Sedangkan berdasarkan hasil penelitian utama diperoleh bahwa produk terpilih flakes yaitu pada perlakuan a3b2 (tepung jagung nikstamal : tepung ubi jalar dan lama pemanggangan selama 20 menit) dengan nilai rata rata kadar air 1,63%, kadar pati 42,71%, kadar serat kasar 2,43%, atribut warna 3,71, aroma terhadap perbandingan tepung sebesar 2,18, aroma terhadap lama pemanggangan 2,09, rasa 3,94 dan kerenyahan 3,79. Kata Kunci: Tepung Jagung Nikstamal, Tepung Tapioka, Tepung Mocaf, Tepung Ubi jalar, Perbandingan Tepung, Lama Pemanggangan, Flake

A Double-Blind, Randomized, Placebo-Controlled Trial of Ursodeoxycholic Acid (UDCA) in Parkinson's Disease

BACKGROUND: Rescue of mitochondrial function is a promising neuroprotective strategy for Parkinson's disease (PD). Ursodeoxycholic acid (UDCA) has shown considerable promise as a mitochondrial rescue agent across a range of preclinical in vitro and in vivo models of PD. OBJECTIVES: To investigate the safety and tolerability of high-dose UDCA in PD and determine midbrain target engagement. METHODS: The UP (UDCA in PD) study was a phase II, randomized, double-blind, placebo-controlled trial of UDCA (30 mg/kg daily, 2:1 randomization UDCA vs. placebo) in 30 participants with PD for 48 weeks. The primary outcome was safety and tolerability. Secondary outcomes included 31-phosphorus magnetic resonance spectroscopy (31 P-MRS) to explore target engagement of UDCA in PD midbrain and assessment of motor progression, applying both the Movement Disorder Society Unified Parkinson's Disease Rating Scale Part III (MDS-UPDRS-III) and objective, motion sensor-based quantification of gait impairment. RESULTS: UDCA was safe and well tolerated, and only mild transient gastrointestinal adverse events were more frequent in the UDCA treatment group. Midbrain 31 P-MRS demonstrated an increase in both Gibbs free energy and inorganic phosphate levels in the UDCA treatment group compared to placebo, reflecting improved ATP hydrolysis. Sensor-based gait analysis indicated a possible improvement of cadence (steps per minute) and other gait parameters in the UDCA group compared to placebo. In contrast, subjective assessment applying the MDS-UPDRS-III failed to detect a difference between treatment groups. CONCLUSIONS: High-dose UDCA is safe and well tolerated in early PD. Larger trials are needed to further evaluate the disease-modifying effect of UDCA in PD. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society

Use of tocilizumab and sarilumab alone or in combination with corticosteroids for covid-19: systematic review and network meta-analysis

Objective: To compare the effects of interleukin 6 receptor blockers, tocilizumab and sarilumab, with or without corticosteroids, on mortality in patients with covid-19. Design: Systematic review and network meta-analysis. Data sources: World Health Organization covid-19 database, a comprehensive multilingual source of global covid-19 literature, and two prospective meta-analyses (up to 9 June 2021). Review methods: Trials in which people with suspected, probable, or confirmed covid-19 were randomised to interleukin 6 receptor blockers (with or without corticosteroids), corticosteroids, placebo, or standard care. The analysis used a bayesian framework and assessed the certainty of evidence using the GRADE approach. Results from the fixed effect meta-analysis were used for the primary analysis. Results: Of 45 eligible trials (20 650 patients) identified, 36 (19 350 patients) could be included in the network meta-analysis. Of 36 trials, 27 were at high risk of bias, primarily due to lack of blinding. Tocilizumab, in combination with corticosteroids, suggested a reduction in the risk of death compared with corticosteroids alone (odds ratio 0.79, 95% credible interval 0.70 to 0.88; 35 fewer deaths per 1000 people, 95% credible interval 52 fewer to 18 fewer per 1000; moderate certainty of evidence), as did sarilumab in combination with corticosteroids, compared with corticosteroids alone (0.73, 0.58 to 0.92; 43 fewer per 1000, 73 fewer to 12 fewer; low certainty). Tocilizumab and sarilumab, each in combination with corticosteroids, appeared to have similar effects on mortality when compared with each other (1.07, 0.86 to 1.34; eight more per 1000, 20 fewer to 35 more; low certainty). The effects of tocilizumab (1.12, 0.91 to 1.38; 20 more per 1000, 16 fewer to 59 more; low certainty) and sarilumab (1.07, 0.81 to 1.40; 11 more per 1000, 38 fewer to 55 more; low certainty), when used alone, suggested an increase in the risk of death. Conclusion: These findings suggest that in patients with severe or critical covid-19, tocilizumab, in combination with corticosteroids, probably reduces mortality, and that sarilumab, in combination with corticosteroids, might also reduce mortality. Tocilizumab and sarilumab, in combination with corticosteroids, could have similar effectiveness. Tocilizumab and sarilumab, when used alone, might not be beneficial.This project is supported by two Canadian Institutes of Health Research grants (VR4-172738; MM1-174897). The funders had no role in considering the study design or in the collection, analysis, interpretation of data, writing of the report, or decision to submit the article for publication.publishedVersio