Aquatic Exercise Is Effective in Improving Exercise Performance in Patients with Heart Failure and Type 2 Diabetes Mellitus

Background. Peak oxygen uptake (VO2peak) and muscle function are more decreased in patients with a combination of chronic heart failure (CHF) and type 2 diabetes mellitus (2DM) compared to patients with only one of the conditions. Further, patients with 2DM have peripheral complications that hamper many types of conventional exercises. Aim. To evaluate the efficacy and applicability of eight-week aquatic exercise in patients with the combination of CHF and 2DM. Methods. Twenty patients (four women) with both CHF and 2DM (age 67.4 ± 7.1, NYHA II-III) were randomly assigned to either aquatic exercise or a control group. The patients exercised for 45 minutes 3 times/week in 33–34°C, swimming pool. Results. The training programme was well tolerated. Work rate (+11.7 ± 6.6 versus −6.4 ± 8.1 watt, P < 0.001) and VO2peak (+2.1 ± 0.8 versus −0.9 ± 1.4 mL·kg−1·min−1, P < 0.001) and walking capacity (P = 0.01) increased significantly in the training group. Muscle function was also significantly improved and Hba1c decreased significantly (P < 0.01) during training, while fasting glucose, insulin, c-peptide, and lipids were unchanged . Training also increased vitality measured by SF-36 significantly (P = 0.05). Conclusion. Aquatic exercise could be used to improve exercise capacity and muscle function in patients with the combination of CHF and 2DM

Aging, rejuvenation, and memory effects in short-range Ising spin glass: Cu0.5_{0.5}Co0.5_{0.5}Cl2_{2}-FeCl3_{3} graphite bi-intercalation compound

Non-equilibrium aging dynamics in 3D Ising spin glass Cu$_{0.5}$Co$_{0.5}$Cl$_{2}$-FeCl$_{3}$ GBIC has been studied by zero-field cooled (ZFC) magnetization and low frequency AC magnetic susceptibility ($f = 0.05$ Hz), where $T_{g} = 3.92 \pm 0.11$ K. The time dependence of the relaxation rate $S(t) = (1/H)$d$M_{ZFC}/$d$\ln t$ for the ZFC magnetization after the ZFC aging protocol, shows a peak at a characteristic time $t_{cr}$ near a wait time $t_{w}$ (aging behavior), corresponding to a crossover from quasi equilibrium dynamics to non-equilibrium. The time $t_{cr}$ strongly depends on $t_{w}$, temperature ($T$), magnetic field ($H$), and the temperature shift ($\Delta T$). The rejuvenation effect is observed in both $\chi^{\prime}$ and $\chi^{\prime\prime}$ under the $T$-shift and $H$-shift procedures. The memory of the specific spin configurations imprinted during the ZFC aging protocol can be recalled when the system is re-heated at a constant heating rate. The aging, rejuvenation, and memory effects observed in the present system are discussed in terms of the scaling concepts derived from numerical studies on 3D Edwards-Anderson spin glass model.Comment: 14 pages, 14 figures; Eur. Phys. J. B accepted for publicatio

Unlocking the unsustainable rice-wheat system of Indian Punjab: Assessing alternatives to crop-residue burning from a systems perspective

Crop residue burning in Indian Punjab emits particulate matter with detrimental impacts on health, climate and that threaten agricultural production. Though legal and technological barriers to residue burning exist – and alternatives considered more profitable to farmers – residue burning continues. We review black carbon (BC) emissions from residue burning in Punjab, analyse social-ecological processes driving residue burning, and rice and wheat value-chains. Our aims are to a) understand system feedbacks driving agricultural practices in Punjab; b) identify systemic effects of alternatives to residue burning and c) identify companies and financial actors investing in agricultural production in Punjab. We find feedbacks locking the system into crop residue burning. The Government of India has greatest financial leverage and risk in the current system. Corporate stakeholders have little financial incentive to enact change, but sufficient stakes in the value chains to influence change. Agricultural policy changes are necessary to reduce harmful impacts of current practices, but insufficient to bringing about sustainability. Transformative changes will require crop diversification, circular business models and green financing. Intermediating financial institutions setting sustainability conditions on loans could leverage these changes. Sustainability requires the systems perspective we provide, to reconnect production with demand and with supporting environmental conditions

Unlocking the unsustainable rice-wheat system of Indian Punjab : assessing alternatives to crop-residue burning from a systems perspective

This work was funded by Formas (Project # 2018-01824), and through the generous support of the Erling-Persson Family Foundation to the Global Economic Dynamics and the Biosphere, the Royal Swedish Academy of Sciences, Sweden.Crop residue burning in Indian Punjab emits particulate matter with detrimental impacts on health, climate and that threaten agricultural production. Though legal and technological barriers to residue burning exist – and alternatives considered more profitable to farmers – residue burning continues. We review black carbon (BC) emissions from residue burning in Punjab, analyse social-ecological processes driving residue burning, and rice and wheat value-chains. Our aims are to a) understand system feedbacks driving agricultural practices in Punjab; b) identify systemic effects of alternatives to residue burning and c) identify companies and financial actors investing in agricultural production in Punjab. We find feedbacks locking the system into crop residue burning. The Government of India has greatest financial leverage and risk in the current system. Corporate stakeholders have little financial incentive to enact change, but sufficient stakes in the value chains to influence change. Agricultural policy changes are necessary to reduce harmful impacts of current practices, but insufficient to bringing about sustainability. Transformative changes will require crop diversification, circular business models and green financing. Intermediating financial institutions setting sustainability conditions on loans could leverage these changes. Sustainability requires the systems perspective we provide, to reconnect production with demand and with supporting environmental conditions.Publisher PDFPeer reviewe

Beta-blockers for heart failure with reduced, mid-range, and preserved ejection fraction:An individual patient-level analysis of double-blind randomized trials

Aims: Recent guidelines recommend that patients with heart failure and left ventricular ejection fraction (LVEF) 40-49% should be managed similar to LVEF ≥ 50%. We investigated the effect of beta-blockers according to LVEF in double-blind, randomized, placebo-controlled trials.  Methods and results: Individual patient data meta-analysis of 11 trials, stratified by baseline LVEF and heart rhythm (Clinicaltrials.gov: NCT0083244; PROSPERO: CRD42014010012). Primary outcomes were all-cause mortality and cardiovascular death over 1.3 years median follow-up, with an intention-to-treat analysis. For 14 262 patients in sinus rhythm, median LVEF was 27% (interquartile range 21-33%), including 575 patients with LVEF 40-49% and 244 ≥ 50%. Beta-blockers reduced all-cause and cardiovascular mortality compared to placebo in sinus rhythm, an effect that was consistent across LVEF strata, except for those in the small subgroup with LVEF ≥ 50%. For LVEF 40-49%, death occurred in 21/292 [7.2%] randomized to beta-blockers compared to 35/283 [12.4%] with placebo; adjusted hazard ratio (HR) 0.59 [95% confidence interval (CI) 0.34-1.03]. Cardiovascular death occurred in 13/292 [4.5%] with beta-blockers and 26/283 [9.2%] with placebo; adjusted HR 0.48 (95% CI 0.24-0.97). Over a median of 1.0 years following randomization (n = 4601), LVEF increased with beta-blockers in all groups in sinus rhythm except LVEF ≥50%. For patients in atrial fibrillation at baseline (n = 3050), beta-blockers increased LVEF when < 50% at baseline, but did not improve prognosis.  Conclusion: Beta-blockers improve LVEF and prognosis for patients with heart failure in sinus rhythm with a reduced LVEF. The data are most robust for LVEF < 40%, but similar benefit was observed in the subgroup of patients with LVEF 40-49%

When is working memory important for arithmetic?: the impact of strategy and age

Our ability to perform arithmetic relies heavily on working memory, the manipulation and maintenance of information in mind. Previous research has found that in adults, procedural strategies, particularly counting, rely on working memory to a greater extent than retrieval strategies. During childhood there are changes in the types of strategies employed, as well as an increase in the accuracy and efficiency of strategy execution. As such it seems likely that the role of working memory in arithmetic may also change, however children and adults have never been directly compared. This study used traditional dual-task methodology, with the addition of a control load condition, to investigate the extent to which working memory requirements for different arithmetic strategies change with age between 9-11 years, 12-14 years and young adulthood. We showed that both children and adults employ working memory when solving arithmetic problems, no matter what strategy they choose. This study highlights the importance of considering working memory in understanding the difficulties that some children and adults have with mathematics, as well as the need to include working memory in theoretical models of mathematical cognition