The 6 minute walk in idiopathic pulmonary fibrosis: longitudinal changes and minimum important difference

The response characteristics of the 6 minute walk test (6MWT) in studies of idiopathic pulmonary fibrosis (IPF) are only poorly understood, and the change in walk distance that constitutes the minimum important difference (MID) over time is unknown

Changes in fetal mannose and other carbohydrates induced by a maternal insulin infusion in pregnant sheep

BACKGROUND: The importance of non-glucose carbohydrates, especially mannose and inositol, for normal development is increasingly recognized. Whether pregnancies complicated by abnormal glucose transfer to the fetus also affect the regulation of non-glucose carbohydrates is unknown. In pregnant sheep, maternal insulin infusions were used to reduce glucose supply to the fetus for both short (2-wk) and long (8-wk) durations to test the hypothesis that a maternal insulin infusion would suppress fetal mannose and inositol concentrations. We also used direct fetal insulin infusions (1-wk hyperinsulinemic-isoglycemic clamp) to determine the relative importance of fetal glucose and insulin for regulating non-glucose carbohydrates. RESULTS: A maternal insulin infusion resulted in lower maternal (50%, P < 0.01) and fetal (35-45%, P < 0.01) mannose concentrations, which were highly correlated (r(2) = 0.69, P < 0.01). A fetal insulin infusion resulted in a 50% reduction of fetal mannose (P < 0.05). Neither maternal nor fetal plasma inositol changed with exogenous insulin infusions. Additionally, maternal insulin infusion resulted in lower fetal sorbitol and fructose (P < 0.01). CONCLUSIONS: Chronically decreased glucose supply to the fetus as well as fetal hyperinsulinemia both reduce fetal non-glucose carbohydrates. Given the role of these carbohydrates in protein glycosylation and lipid production, more research on their metabolism in pregnancies complicated by abnormal glucose metabolism is clearly warranted

Development of the ATAQ-IPF: a tool to assess quality of life in IPF

<p>Abstract</p> <p>Background</p> <p>There is no disease-specific instrument to assess health-related quality of life (HRQL) in patients with idiopathic pulmonary fibrosis (IPF).</p> <p>Methods</p> <p>Patients' perspectives were collected to develop domains and items for an IPF-specific HRQL instrument. We used item variance and Rasch analysis to construct the ATAQ-IPF (A Tool to Assess Quality of life in IPF).</p> <p>Results</p> <p>The ATAQ-IPF version 1 is composed of 74 items comprising 13 domains. All items fit the Rasch model. Domains and the total instrument possess acceptable psychometric characteristics for a multidimensional questionnaire. The pattern of correlations between ATAQ-IPF scores and physiologic variables known to be important in IPF, along with significant differences in ATAQ-IPF scores between subjects using versus those not using supplemental oxygen, support its validity.</p> <p>Conclusions</p> <p>Patient-centered and careful statistical methodologies were used to construct the ATAQ-IPF version 1, an IPF-specific HRQL instrument. Simple summation scoring is used to derive individual domain scores as well as a total score. Results support the validity of the ATAQ-IPF, and future studies will build on that validity.</p

Age Differences in the Association of Obstructive Sleep Apnea Risk with Cognition and Quality of Life

Using a sample of 2925 stroke-free participants drawn from a national population-based study, we examined cross-sectional associations of obstructive sleep apnea risk (OSA) with cognition and quality of life and whether these vary with age, while controlling for demographics and co-morbidities. Included participants from the REasons for Geographic And Racial Differences in Stroke Study were aged 47-93. OSA risk was categorized as high or low based on responses to the Berlin Sleep Questionnaire. Cognitive function was assessed with standardized fluency and recall measures. Depressive symptoms were assessed with the four-item Center for Epidemiologic Studies Depression Scale. Health-related Quality of Life (HRQoL) was assessed with the Medical Outcomes Study Short Form-12 (SF-12). MANCOVA statistics were applied separately to the cognitive and quality of life dependent variables while accounting for potential confounders (demographics, co-morbidities). In fully adjusted models, those at high risk for OSA had significantly lower cognitive scores (Wilks’ Lambda = 0.996, F(3, 2786) = 3.31, p < .05) and lower quality of life (depressive symptoms and HRQoL) (Wilks’ Lambda = 0.989, F(3, 2786) = 10.02, p < .0001). However, some of the associations were age-dependent. Differences in cognition and quality of life between those at high and low obstructive sleep apnea risk were most pronounced during middle age, with attenuated effects after age 70

A Spitzer c2d Legacy Survey to Identify and Characterize Disks with Inner Dust Holes

Understanding how disks dissipate is essential to studies of planet formation. However, identifying exactly how dust and gas dissipates is complicated due to difficulty in finding objects clearly in the transition of losing their surrounding material. We use Spitzer IRS spectra to examine 35 photometrically-selected candidate cold disks (disks with large inner dust holes). The infrared spectra are supplemented with optical spectra to determine stellar and accretion properties and 1.3mm photometry to measure disk masses. Based on detailed SED modeling, we identify 15 new cold disks. The remaining 20 objects have IRS spectra that are consistent with disks without holes, disks that are observed close to edge-on, or stars with background emission. Based on these results, we determine reliable criteria for identifying disks with inner holes from Spitzer photometry and examine criteria already in the literature. Applying these criteria to the c2d surveyed star-forming regions gives a frequency of such objects of at least 4% and most likely of order 12% of the YSO population identified by Spitzer. We also examine the properties of these new cold disks in combination with cold disks from the literature. Hole sizes in this sample are generally smaller than for previously discovered disks and reflect a distribution in better agreement with exoplanet orbit radii. We find correlations between hole size and both disk and stellar masses. Silicate features, including crystalline features, are present in the overwhelming majority of the sample although 10 micron feature strength above the continuum declines for holes with radii larger than ~7 AU. In contrast, PAHs are only detected in 2 out of 15 sources. Only a quarter of the cold disk sample shows no signs of accretion, making it unlikely that photoevaporation is the dominant hole forming process in most cases.Comment: 24 pages, 18 figures and 8 tables. Fixed a typo in Table

Observations of T-Tauri Stars using HST-GHRS: I. Far Ultraviolet Emission Lines

We have analyzed GHRS data of eight CTTS and one WTTS. The GHRS data consists of spectral ranges 40 A wide centered on 1345, 1400, 1497, 1550, and 1900 A. These UV spectra show strong SiIV, and CIV emission, and large quantities of sharp (~40 km/s) H2 lines. All the H2 lines belong to the Lyman band and all the observed lines are single peaked and optically thin. The averages of all the H2 lines centroids for each star are negative which may indicate that they come from an outflow. We interpret the emission in H2 as being due to fluorescence, mostly by Ly_alpha, and identify seven excitation routes within 4 A of that line. We obtain column densities (10^12 to 10^15 cm^-2) and optical depths (~1 or less) for each exciting transition. We conclude that the populations are far from being in thermal equilibrium. We do not observe any lines excited from the far blue wing of Ly_alpha, which implies that the molecular features are excited by an absorbed profile. SiIV and CIV (corrected for H2 emission) have widths of ~200 km/s, and an array of centroids (blueshifted lines, centered, redshifted). These characteristics are difficult to understand in the context of current models of the accretion shock. For DR Tau we observe transient strong blueshifted emission, perhaps the a result of reconnection events in the magnetosphere. We also see evidence of multiple emission regions for the hot lines. While CIV is optically thin in most stars in our sample, SiIV is not. However, CIV is a good predictor of SiIV and H2 emission. We conclude that most of the flux in the hot lines may be due to accretion processes, but the line profiles can have multiple and variable components.Comment: 67 pages, 19 figures, Accepted in Ap

Self-consistent description of nuclear compressional modes

Isoscalar monopole and dipole compressional modes are computed for a variety of closed-shell nuclei in a relativistic random-phase approximation to three different parametrizations of the Walecka model with scalar self-interactions. Particular emphasis is placed on the role of self-consistency which by itself, and with little else, guarantees the decoupling of the spurious isoscalar-dipole strength from the physical response and the conservation of the vector current. A powerful new relation is introduced to quantify the violation of the vector current in terms of various ground-state form-factors. For the isoscalar-dipole mode two distinct regions are clearly identified: (i) a high-energy component that is sensitive to the size of the nucleus and scales with the compressibility of the model and (ii) a low-energy component that is insensitivity to the nuclear compressibility. A fairly good description of both compressional modes is obtained by using a ``soft'' parametrization having a compression modulus of K=224 MeV.Comment: 28 pages and 10 figures; submitted to PR

Reflecting on loss in Papua New Guinea

This article takes up the conundrum of conducting anthropological fieldwork with people who claim that they have 'lost their culture,' as is the case with Suau people in the Massim region of Papua New Guinea. But rather than claiming culture loss as a process of dispossession, Suau claim it as a consequence of their own attempts to engage with colonial interests. Suau appear to have responded to missionization and their close proximity to the colonial-era capital by jettisoning many of the practices characteristic of Massim societies, now identified as 'kastom.' The rejection of kastom in order to facilitate their relations with Europeans during colonialism, followed by the mourning for kastom after independence, both invite consideration of a kind of reflexivity that requires action based on the presumed perspective of another