Overweight and obese adults have low intentions of seeking weight-related care:A cross-sectional survey

Background The prevalence of obesity is growing worldwide. Obesity guidelines recommend increasing the level of weight-related care for persons with elevated levels of weight-related health risk (WRHR). However, there seems to be a discrepancy between need for and use of weight-related care. The primary aim of this study is to examine predisposing factors that may influence readiness to lose weight and intention to use weight-related care in an overweight population. Methods A population-based, cross-sectional survey was conducted. Data were collected using an online self-administered questionnaire sent to a population-representative sample of 1,500 Dutch adults on the Health Care Consumer Panel (n = 861 responded). Data were used from individuals (n = 445) with a mildly, moderately or severely elevated level of WRHR. WRHR status was based on self-reported data on Body Mass Index, risk assessment for diabetes mellitus type 2 (DM2) and cardiovascular disease (CVD), or co-morbidities. Results 55.1% of persons with increased WRHR were ready to lose weight (n = 245). Depending on level of WRHR; educational level, marital status, individuals with an accurate perception of their weight and better perceptions and expectations of dietitians were significantly related to readiness to lose weight. Most of them preferred individual weight-loss methods (82.0% of n = 245). 11% (n = 26 of n = 245) intended to use weight-related care. Weight-related care seeking was higher for those with moderate or severe WRHR. Expectations and trust in dietitians did not seem to influence care seeking. Conclusions Many Dutch adults who are medically in need of weight-related care are ready to lose weight. Most intend to lose weight individually, and only a few intend to use weight-related care. Therefore, obesity prevention initiatives should focus on monitoring weight change and weight-loss plans, and timely referral to obesity management. However, many people are not ready to lose weight. For this group, strategies for behaviour change may depend on WRHR, perceptions of weight and dietitians, educational level and marital status. Obesity prevention initiatives should focus on increasing the awareness of the seriousness of their condition and offering individually appropriate weight management programmes. Keywords: Overweight, Obesity, Weight change, Patient’s acceptance of health care, Perception, Dietary service

Simulation of VUV electroluminescence in micropattern gaseous detectors: the case of GEM and MHSP

Electroluminescence produced during avalanche development in gaseous avalanche detectors is an useful information for triggering, calorimetry and tracking in gaseous detectors. Noble gases present high electroluminescence yields, emitting mainly in the VUV region. The photons can provide signal readout if appropriate photosensors are used. Micropattern gaseous detectors are good candidates for signal amplification in high background and/or low rate experiments due to their high electroluminescence yields and radiopurity. In this work, the VUV light responses of the Gas Electron Multiplier and of the Micro-Hole Strip Plate, working with pure xenon, are simulated and studied in detail using a new and versatile C++ toolkit. It is shown that the solid angle subtended by a photosensor placed below the microstructures depends on the operating conditions. The obtained absolute EL yields, determined for different gas pressures and as functions of the applied voltage, are compared with those determined experimentally.Comment: Accepted for publication in Journal of Instrumentatio

Effects of High Charge Densities in Multi-GEM Detectors

A comprehensive study, supported by systematic measurements and numerical computations, of the intrinsic limits of multi-GEM detectors when exposed to very high particle fluxes or operated at very large gains is presented. The observed variations of the gain, of the ion back-flow, and of the pulse height spectra are explained in terms of the effects of the spatial distribution of positive ions and their movement throughout the amplification structure. The intrinsic dynamic character of the processes involved imposes the use of a non-standard simulation tool for the interpretation of the measurements. Computations done with a Finite Element Analysis software reproduce the observed behaviour of the detector. The impact of this detailed description of the detector in extreme conditions is multiple: it clarifies some detector behaviours already observed, it helps in defining intrinsic limits of the GEM technology, and it suggests ways to extend them.Comment: 5 pages, 6 figures, 2015 IEEE Nuclear Science Symposiu

Modelling the behaviour of microbulk Micromegas in Xenon/trimethylamine gas

We model the response of a state of the art micro-hole single-stage charge amplication device (`microbulk' Micromegas) in a gaseous atmosphere consisting of Xenon/trimethylamine at various concentrations and pressures. The amplifying structure, made with photo-lithographic techniques similar to those followed in the fabrication of gas electron multipliers (GEMs), consisted of a 100 um-side equilateral-triangle pattern with 50 um-diameter holes placed at its vertexes. Once the primary electrons are guided into the holes by virtue of an optimized field configuration, avalanches develop along the 50 um-height channels etched out of the original doubly copper-clad polyimide foil. In order to properly account for the strong field gradients at the holes' entrance as well as for the fluctuations of the avalanche process (that ultimately determine the achievable energy resolution), we abandoned the hydrodynamic framework, resorting to a purely microscopic description of the electron trajectories as obtained from elementary cross-sections. We show that achieving a satisfactory description needs additional assumptions about atom-molecule (Penning) transfer reactions and charge recombination to be made

Mitoxantrone in metastatic apudomas: a phase II study of the EORTC Gastro-Intestinal Cancer Cooperative Group.

We performed a phase II study with mitoxantrone in patients with carcinoid tumours, islet cell tumours and medullary carcinomas of the thyroid. Thirty-five eligible patients received mitoxantrone 12 mg m-2 i.v. every 3 weeks. Among 18 previously untreated patients, three responded (17%, 95% CI = 4-41%); no responses were achieved in 17 previously treated patients. Of the 21 patients who had carcinoid tumours, 11 were previously untreated and two achieved a response (18%, 95% CI = 2-52%). Overall response rate was 9% (95% CI = 2-23%). At a median follow-up of 43 months, median overall survival was 16 months. The median survival of 21 patients with a normal alkaline phosphatase was 29 months and 9 months for 14 patients with elevated serum levels (P = 0.005). A similar observation was noticed for gamma-glutamyltransferase (P = 0.007). We concluded that mitoxantrone is not active in APUD tumours. Elevated alkaline phosphatase and gamma-glutamyltransferase are associated with a poor prognosis

Charge Transfer Properties Through Graphene for Applications in Gaseous Detectors

Graphene is a single layer of carbon atoms arranged in a honeycomb lattice with remarkable mechanical and electrical properties. Regarded as the thinnest and narrowest conductive mesh, it has drastically different transmission behaviours when bombarded with electrons and ions in vacuum. This property, if confirmed in gas, may be a definitive solution for the ion back-flow problem in gaseous detectors. In order to ascertain this aspect, graphene layers of dimensions of about 2x2cm$^2$, grown on a copper substrate, are transferred onto a flat metal surface with holes, so that the graphene layer is freely suspended. The graphene and the support are installed into a gaseous detector equipped with a triple Gaseous Electron Multiplier (GEM), and the transparency properties to electrons and ions are studied in gas as a function of the electric fields. The techniques to produce the graphene samples are described, and we report on preliminary tests of graphene-coated GEMs.Comment: 4pages, 3figures, 13th Pisa Meeting on Advanced Detector

Recombinant human interleukin 6 in metastatic renal cell cancer: a phase II trial.

A phase II trial investigating the anti-tumour effects of recombinant human interleukin 6 (rhIL-6) in patients with metastatic renal cell cancer was carried out. RhIL-6 (150 microgram) was administered as a daily subcutaneous injection for 42 consecutive days on an outpatient basis. Forty-nine patients were studied, 12 with and 37 without previous immunotherapy. Forty patients were evaluable for response. A partial remission was noted in two patients, stable disease in 17 and progressive disease in 21. Toxicity was moderate and reversible and consisted mainly of fever, flu-like symptoms, nausea, weight loss and hepatotoxicity. Anaemia, leucocytosis and thrombocytosis and induction of acute phase protein synthesis were noted in most patients. In 15% of the patients anti-IL-6 antibodies developed, and were neutralising in only one patient. Baseline plasma IL-6 concentrations did not correlate with tumour behaviour before or after rhIL-6 treatment. In conclusion, rhIL-6 can be safely administered on an outpatient basis for prolonged period of time and has moderate, reversible toxicity. Its administration induces IL-6-antibody production in only a minority of patients. Antitmour effects of rhIL-6 in metastatic renal cancer are limited

Healthcare utilization patterns for knee and hip osteoarthritis before and after changes in national health insurance coverage:A data linkage study from the Netherlands

Introduction: Medical guidelines aim to stimulate stepped care for knee and hip osteoarthritis, redirecting treatments from hospitals to primary care. In the Netherlands, this development was supported by changing health insurance coverage for physio/exercise therapy. The aim of this study was to evaluate healthcare utilization patterns before and after health changes in health insurance coverage. Method: We analyzed electronic health records and claims data from patients with osteoarthritis in the knee (N =32,091) and hip (N = 16,313). Changes between 2013 and 2019 in the proportion of patients treated by the general practitioner, physio/exercise therapist or orthopedic surgeon within 6 months after onset were assessed. Results: Joint replacement surgeries decreased for knee (OR 0.47 [0.41–0.54]) and hip (OR 0.81 [0.71–0.93]) osteoarthritis between 2013–2019. The use of physio/exercise therapy increased (knee: OR 1.38 [1.24–1.53], hip: OR 1.26 [1.08–1.47]). However, the proportion treated by a physio/exercise therapist decreased for patients that had not depleted their annual deductibles (knee: OR 0.86 [0.79 – 0.94], hip: OR 0.90 [0.79 – 1.02]). This might be affected by the inclusion of physio/exercise therapy in basic health insurance in 2018. Conclusion:We have found a shift from hospitals to primary care in knee and hip osteoarthritis care. However, the use of physio/exercise therapy declined after changes in insurance coverage for patients that had not depleted their deductibles

Study of dimuon production in Indium-Indium collisions with the NA60 experiment

The NA60 experiment at the CERN-SPS is devoted to the study of dimuon production in heavy-ion and proton-nucleus collisions. We present preliminary results from the analysis of Indium-Indium collisions at 158 GeV per nucleon. The topics covered are low mass vector meson production, J/psi production and suppression, and the feasibility of the open charm measurement from the dimuon continuum in the mass range below the J/psi peak.Comment: Contribution at XXXXth Rencontres de Moriond, "QCD and High Energy Hadronic Interactions

ϕ\phi Meson Production in In-In Collisions and the ϕ\phi Puzzle

The NA60 experiment measured dimuon production in In-In collisions at 158 AGeV. This paper presents a high statistics measurement of $\phi\to\mu\mu$ with the specific objective to provide insight on the $\phi$ puzzle, i.e. the difference in the inverse $T$ slopes and absolute yields measured by NA49 and NA50 in the kaon and lepton channel, respectively. Transverse momentum distributions were studied as a function of centrality. The slope parameter $T$ shows a rapid increase with centrality, followed by a saturation. Variations of $T$ with the fit range of the order of 15 MeV were observed, possibly as a consequence of radial flow. The $\phi$ meson yield normalized to the number of participants increases with centrality and is consistently higher than the yield measured by the NA49 experiment at any centrality.Comment: 4 Pages, 2 Figures. Proceedings of the 20$^{th}$ International Conference on Ultra-Relativistic Nucleus Nucleus Collision