The effects of a low-carbohydrate, ketogenic diet on the polycystic ovary syndrome: A pilot study

BACKGROUND: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting women of reproductive age and is associated with obesity, hyperinsulinemia, and insulin resistance. Because low carbohydrate diets have been shown to reduce insulin resistance, this pilot study investigated the six-month metabolic and endocrine effects of a low-carbohydrate, ketogenic diet (LCKD) on overweight and obese women with PCOS. RESULTS: Eleven women with a body mass index >27 kg/m(2 )and a clinical diagnosis of PCOS were recruited from the community. They were instructed to limit their carbohydrate intake to 20 grams or less per day for 24 weeks. Participants returned every two weeks to an outpatient research clinic for measurements and reinforcement of dietary instruction. In the 5 women who completed the study, there were significant reductions from baseline to 24 weeks in body weight (-12%), percent free testosterone (-22%), LH/FSH ratio (-36%), and fasting insulin (-54%). There were non-significant decreases in insulin, glucose, testosterone, HgbA1c, triglyceride, and perceived body hair. Two women became pregnant despite previous infertility problems. CONCLUSION: In this pilot study, a LCKD led to significant improvement in weight, percent free testosterone, LH/FSH ratio, and fasting insulin in women with obesity and PCOS over a 24 week period

Englanti–suomi-koodinvaihto Suomeen muuttaneiden henkilöiden puhumassa kielessä

Tiivistelmä. Tutkin kandidaatintutkielmassani Suomeen muuttaneiden henkilöiden englanti–suomi-koodinvaihtoa. Tarkastelen tutkimuksessani koodinvaihtoon osallistuvaa sanastoa merkityksen näkökulmasta. Tutkin, millaista koodinvaihtoa tutkimusaineistossani ilmenee englannin ja suomen välillä, ja millaisia yhtymäkohtia tutkimustuloksillani on aiempien tutkimustulosten kanssa. Lisäksi selvitän informanttien metakielellisten kommenttien, lähdekirjallisuuden sekä oman tulkintani avulla mahdollisia syitä sille, miksi osa tutkimusaineistoni sanoista osallistuu koodinvaihtoon muita sanoja todennäköisemmin. Tutkimukseni edustaa aineistovetoista koodinvaihtotutkimusta. Aineistoni koostuu kahdesta Oulun yliopiston Kikosa-kokoelmaan kuuluvasta haastattelusta sekä yhdestä arkikeskustelusta. Hyödynnän tutkimuksessani edellä mainituista tehtyjä litteraatteja. Olen jaotellut tutkimusaineistosta löytyvät koodinvaihtotapaukset merkityksen perusteella neljään aiheryhmään, jotka ovat koulutussanasto, työ- ja ammattisanasto, tervehdykset, toivotukset ja kohteliaisuusfraasit sekä muu suomenkieliseen arkeen liittyvä sanasto. Olen vertaillut tutkimusaineiston koodinvaihtotapauksia pääsääntöisesti Backusin (2001) sekä Ben-Rafaelin (2001) tutkimustuloksiin. Tutkimustuloksistani löytyy yhtäläisyyksiä heidän tutkimustuloksiensa kanssa etenkin koulutussanaston sekä työ- ja ammattisanaston osalta. Tutkimukseni tulosten perusteella syyt aineistoesimerkkien koodinvaihdon taustalla ovat moninaisia. Tutkimustulokseni ovat pääosin linjassa Backusin (2001) semanttisen spesifisyyden teorian sekä semanttisen alueen hypoteesin kanssa. Semanttisesti erittäin spesifejä sanoja ovat tutkimusaineistossani etenkin kulttuurisidonnaiset sanat, joiden mahdollisella matriisikielen mukaisella vastineella ei välttämättä ole täysin sama merkitys. Lisäksi osalla informanteista on ollut kokemusta esimerkiksi kouluttautumisesta tai työelämästä Suomessa, jolloin näihin semanttisiin alueisiin liittyvä suomenkielinen sanasto on tullut osaksi heidän kielenkäyttöään. Koodinvaihtoa voi myös motivoida muun muassa se, että kielenpuhuja ei tiedä matriisikielen mukaista vastinetta. Informanttien metakielellisten kommenttien perusteella myös ymmärretyksi tuleminen vaikutti olevan merkittävä syy koodinvaihdolle

A low-carbohydrate, ketogenic diet to treat type 2 diabetes

BACKGROUND: The low-carbohydrate, ketogenic diet (LCKD) may be effective for improving glycemia and reducing medications in patients with type 2 diabetes. METHODS: From an outpatient clinic, we recruited 28 overweight participants with type 2 diabetes for a 16-week single-arm pilot diet intervention trial. We provided LCKD counseling, with an initial goal of <20 g carbohydrate/day, while reducing diabetes medication dosages at diet initiation. Participants returned every other week for measurements, counseling, and further medication adjustment. The primary outcome was hemoglobin A(1c). RESULTS: Twenty-one of the 28 participants who were enrolled completed the study. Twenty participants were men; 13 were White, 8 were African-American. The mean [± SD] age was 56.0 ± 7.9 years and BMI was 42.2 ± 5.8 kg/m(2). Hemoglobin A(1c )decreased by 16% from 7.5 ± 1.4% to 6.3 ± 1.0% (p < 0.001) from baseline to week 16. Diabetes medications were discontinued in 7 participants, reduced in 10 participants, and unchanged in 4 participants. The mean body weight decreased by 6.6% from 131.4 ± 18.3 kg to 122.7 ± 18.9 kg (p < 0.001). In linear regression analyses, weight change at 16 weeks did not predict change in hemoglobin A(1c). Fasting serum triglyceride decreased 42% from 2.69 ± 2.87 mmol/L to 1.57 ± 1.38 mmol/L (p = 0.001) while other serum lipid measurements did not change significantly. CONCLUSION: The LCKD improved glycemic control in patients with type 2 diabetes such that diabetes medications were discontinued or reduced in most participants. Because the LCKD can be very effective at lowering blood glucose, patients on diabetes medication who use this diet should be under close medical supervision or capable of adjusting their medication

Physical interpretation of the Wigner rotations and its implications for relativistic quantum information

We present a new treatment for the spin of a massive relativistic particle in the context of quantum information based on a physical interpretation of the Wigner rotations, obtaining different results in relation to the previous works. We are lead to the conclusions that it is not possible to define a reduced density matrix for the particle spin and that the Pauli-Lubanski (or similar) spin operators are not suitable to describe measurements where spin couples to an electromagnetic field in the measuring apparatus. These conclusions contradict the assumptions made by most of the previous papers on the subject. We also propose an experimental test of our formulation.Comment: 10 pages, 2 figures. Several changes were made on the text. One extra example was include

Impact of CKD Progression on Cardiovascular Disease Risk in a Contemporary UK Cohort of Individuals With Diabetes

Introduction: It remains unclear whether an increased progression rate of chronic kidney disease (CKD) adds predictive information regarding cardiovascular disease (CVD) risk. The aim of this study was to evaluate the association between CKD progression, based on estimated glomerular filtration rate (eGFR) slope estimates and the risk for CVD. Methods: We compared the updated eGFR slope calculated over multiple overlapping 2-year periods and the updated mean eGFR. Incident CKD subjects were selected from a prevalent population with diabetes (T2DM). Subjects from the UK Clinical Practice Research Data Link GOLD (CPRD) were followed from CKD diagnosis (n = 30,222) until heart failure (HF), myocardial infarction (MI), ischemic stroke (IS), or a composite end point including all 3 event types (MACE plus), mortality, database dropout, or end of study follow-up. Results: Both the updated eGFR slope and updated mean eGFR were associated with MACE plus and HF. Updated eGFR slope decline of &gt; –3 ml/min/1.73 m2 increased the risk for MACE plus (adjusted hazard ratio [HR] = 1.45; 95% confidence interval [CI], 1.26–1.67), HF (HR = 1.50; 95% CI, 1.27–1.76), and MI (HR = 1.39; 95% CI, 1.01–1.91). Conclusions: This study strongly supports current evidence that CKD is an independent risk factor for CVD. From a clinical perspective, both rate of progression and cumulative status of CKD describe distinct aspects of the cardiorenal risk among persons with diabetes. This evidence is essential to enable more timely and improved use of treatments in this population

Impressões sobre o teste rápido para o HIV entre usuários de drogas injetáveis no Brasil

OBJECTIVE: To describe perceptions, experiences, knowledge, beliefs and the willingness of injecting drug users to be HIV tested by using rapid tests. METHODS: A qualitative exploratory study was carried out among injecting drug users from December 2003 to February 2004 in five Brazilian cities, located in four regions of Brazil. A semi-structured interview guide containing both closed and open-ended questions was used to address perceptions about non-conventional testing procedures, and non-traditional ways to provide testing access to injecting drug users. A total of 106 interviews, about 26 per region, were conducted. RESULTS: Characteristics of the population studied, common thoughts about HIV rapid testing, preference for using blood or saliva specimens, and other testing preferences, were presented together with reported advantages and disadvantages of each option. The study findings showed that the use of rapid tests among these users is feasible and that they are willing to be tested using rapid HIV tests, especially if some issues related to privacy and reliability of the test could be addressed. CONCLUSIONS: The study findings showed that rapid tests may be well accepted for this population. These tests can be considered a valuable tool, allowing a more injecting drug users to learn their HIV status and possibly be referred to treatment and should support more effective testing strategies for them.OBJETIVO: Descrever as impressões, experiências, conhecimentos, crenças e a receptividade de usuários de drogas injetáveis para participar das estratégias de testagem rápida para HIV. MÉTODOS: Estudo qualitativo exploratório foi conduzido entre usuários de drogas injetáveis, de dezembro de 2003 a fevereiro de 2004, em cinco cidades brasileiras, localizadas em quatro regiões do País. Um roteiro de entrevista semi-estruturado contendo questões fechadas e abertas foi usado para avaliar percepções desses usuários sobre procedimentos e formas alternativas de acesso e testagem. Foram realizadas 106 entrevistas, aproximadamente 26 por região. RESULTADOS: Características da população estudada, opiniões sobre o teste rápido e preferências por usar amostras de sangue ou saliva foram apresentadas junto com as vantagens e desvantagens associadas a cada opção. Os resultados mostraram a viabilidade do uso de testes rápidos entre usuários de drogas injetáveis e o interesse deles quanto à utilização destes métodos, especialmente se puderem ser equacionadas questões relacionadas à confidencialidade e confiabilidade dos testes. CONCLUSÕES: Os resultados indicam que os testes rápidos para HIV seriam bem recebidos por essa população. Esses testes podem ser considerados uma ferramenta valiosa, ao permitir que mais usuários de drogas injetáveis conheçam sua sorologia para o HIV e possam ser referidos para tratamento, como subsidiar a melhoria das estratégias de testagem entre usuários de drogas injetáveis

Cerebrospinal fluid biomarkers of brain injury, inflammation and synaptic autoimmunity predict long-term neurocognitive outcome in herpes simplex encephalitis

OBJECTIVES: To investigate the correlation between biomarkers of brain injury and long-term neurocognitive outcome, and the interplay with intrathecal inflammation and neuronal autoimmunity, in patients with herpes simplex encephalitis (HSE). METHODS: A total of 53 adult/adolescent HSE patients were included from a prospective cohort in a randomized placebo-controlled trial investigating the effect of a 3-month follow-up treatment with valaciclovir. Study subjects underwent repeated serum/CSF sampling and brain MRI the first 3 months along with cognitive assessment by Mattis Dementia Rating Scale (MDRS) during 24 months. CSF samples were analyzed for biomarkers of brain injury, inflammation and synaptic autoimmunity. The pre-defined primary analysis was the correlation between peak CSF neurofilament protein (NFL), a biomarker of neuronal damage, and MDRS at 24 months. RESULTS: Impaired cognitive performance significantly correlated with NFL levels (rho = -0.36, p = 0.020). Development of IgG anti-N-methyl-D-aspartate receptor (NDMAR) antibodies was associated with a broad and prolonged proinflammatory CSF response. In a linear regression model, lower MDRS at 24 months was associated with previous development of IgG anti-NMDAR (beta = -0.6249, p = 0.024) and age (z-score beta = -0.2784, p = 0.024), but not CSF NFL, which however significantly correlated with subsequent NMDAR autoimmunization (p = 0.006). CONCLUSIONS: Our findings show that NFL levels are predictive of long-term neurocognitive outcome in HSE, and suggest a causative chain of events where brain tissue damage increases the risk of NMDAR autoimmunisation and subsequent prolongation of CSF inflammation. The data provides guidance for a future intervention study of immunosuppressive therapy administered in the recovery phase of HSE

Effects of amyloid pathology and the APOE ε4 allele on the association between cerebrospinal fluid Aβ38 and Aβ40 and brain morphology in cognitively normal 70-years-olds

The association between cerebrospinal fluid (CSF) amyloid beta (Aβ) Aβ38 or Aβ40 and brain grey- and white matter integrity is poorly understood. We studied this in 213 cognitively normal 70-year-olds, and in subgroups defined by presence/absence of the APOE ε4 allele and Aβ pathology: Aβ−/APOE−, Aβ+/APOE−, Aβ−/APOE+ and Aβ+/APOE+. CSF Aβ was quantified using ELISA and genotyping for APOE was performed. Low CSF Aβ42 defined Aβ plaque pathology. Brain volumes were assessed using Freesurfer-5.3, and white matter integrity using tract-based statistics in FSL. Aβ38 and Aβ40 were positively correlated with cortical thickness, some subcortical volumes and white matter integrity in the total sample, and in 3 of the subgroups: Aβ−/APOE−, Aβ+/APOE− and Aβ−/APOE+. In Aβ+/APOE+ subjects, higher Aβ38 and Aβ40 were linked to reduced cortical thickness and subcortical volumes. We hypothesize that production of all Aβ species decrease in brain regions with atrophy. In Aβ+/APOE+, Aβ-dysregulation may be linked to cortical atrophy in which high Aβ levels is causing pathological changes in the gray matter of the brain

Deep learning from MRI-derived labels enables automatic brain tissue classification on human brain CT

Automatic methods for feature extraction, volumetry, and morphometric analysis in clinical neuroscience typically operate on images obtained with magnetic resonance (MR) imaging equipment. Although CT scans are less expensive to acquire and more widely available than MR scans, their application is currently limited to the visual assessment of brain integrity and the exclusion of co-pathologies. CT has rarely been used for tissue classification because the contrast between grey matter and white matter was considered insufficient. In this study, we propose an automatic method for segmenting grey matter (GM), white matter (WM), cerebrospinal fluid (CSF), and intracranial volume (ICV) from head CT images. A U-Net deep learning model was trained and validated on CT images with MRI-derived segmentation labels. We used data from 744 participants of the Gothenburg H70 Birth Cohort Studies for whom CT and T1-weighted MR images had been acquired on the same day. Our proposed model predicted brain tissue classes accurately from unseen CT images (Dice coefficients of 0.79, 0.82, 0.75, 0.93 and 0.98 for GM, WM, CSF, brain volume and ICV, respectively). To contextualize these results, we generated benchmarks based on established MR-based methods and intentional image degradation. Our findings demonstrate that CT-derived segmentations can be used to delineate and quantify brain tissues, opening new possibilities for the use of CT in clinical practice and research