183 research outputs found

    Analysis of the distributions of hourly NO2 concentrations contributing to annual average NO2 concentrations across the European monitoring network between 2000 and 2014

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    Exposure to nitrogen dioxide (NO2) is associated with negative human health effects, both for short-term peak concentrations and from long-term exposure to a wider range of NO2 concentrations. For the latter, the European Union has established an air quality limit value of 40 µg m−3 as an annual average. However, factors such as proximity and strength of local emissions, atmospheric chemistry, and meteorological conditions mean that there is substantial variation in the hourly NO2 concentrations contributing to an annual average concentration. The aim of this analysis was to quantify the nature of this variation at thousands of monitoring sites across Europe through the calculation of a standard set of chemical climatology statistics. Specifically, at each monitoring site that satisfied data capture criteria for inclusion in this analysis, annual NO2 concentrations, as well as the percentage contribution from each month, hour of the day, and hourly NO2 concentrations divided into 5 µg m−3 bins were calculated. Across Europe, 2010–2014 average annual NO2 concentrations (NO2AA) exceeded the annual NO2 limit value at 8 % of > 2500 monitoring sites. The application of this chemical climatology approach showed that sites with distinct monthly, hour of day, and hourly NO2 concentration bin contributions to NO2AA were not grouped into specific regions of Europe, furthermore, within relatively small geographic regions there were sites with similar NO2AA, but with differences in these contributions. Specifically, at sites with highest NO2AA, there were generally similar contributions from across the year, but there were also differences in the contribution of peak vs. moderate hourly NO2 concentrations to NO2AA, and from different hours across the day. Trends between 2000 and 2014 for 259 sites indicate that, in general, the contribution to NO2AA from winter months has increased, as has the contribution from the rush-hour periods of the day, while the contribution from peak hourly NO2 concentrations has decreased. The variety of monthly, hour of day and hourly NO2 concentration bin contributions to NO2AA, across cities, countries and regions of Europe indicate that within relatively small geographic areas different interactions between emissions, atmospheric chemistry and meteorology produce variation in NO2AA and the conditions that produce it. Therefore, measures implemented to reduce NO2AA in one location may not be as effective in others. The development of strategies to reduce NO2AA for an area should therefore consider (i) the variation in monthly, hour of day, and hourly NO2 concentration bin contributions to NO2AA within that area; and (ii) how specific mitigation actions will affect variability in hourly NO2 concentrations

    A smartphone-supported weight loss program: design of the ENGAGED randomized controlled trial

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    Background Obesity remains a major public health challenge, demanding cost-effective and scalable weight management programs. Delivering key treatment components via mobile technology offers a potential way to reduce expensive in-person contact, thereby lowering the cost and burden of intensive weight loss programs. The ENGAGED study is a theory-guided, randomized controlled trial designed to examine the feasibility and efficacy of an abbreviated smartphone-supported weight loss program. Methods/design Ninety-six obese adults (BMI 30–39.9 kg/m2) will be randomized to one of three treatment conditions: (1) standard behavioral weight loss (STND), (2) technology-supported behavioral weight loss (TECH); or (3) self-guided behavioral weight loss (SELF). All groups will aim to achieve a 7% weight loss goal by reducing calorie and fat intake and progressively increasing moderate intensity physical activity to 175 minutes/week. STND and TECH will attend 8 group sessions and receive regular coaching calls during the first 6 months of the intervention; SELF will receive the Group Lifestyle Balance Program DVD’s and will not receive coaching calls. During months 1–6, TECH will use a specially designed smartphone application to monitor dietary intake, body weight, and objectively measured physical activity (obtained from a Blue-tooth enabled accelerometer). STND and SELF will self-monitor on paper diaries. Linear mixed modeling will be used to examine group differences on weight loss at months 3, 6, and 12. Self-monitoring adherence and diet and activity goal attainment will be tested as mediators. Discussion ENGAGED is an innovative weight loss intervention that integrates theory with emerging mobile technologies. We hypothesize that TECH, as compared to STND and SELF, will result in greater weight loss by virtue of improved behavioral adherence and goal achievement. Trial registration NCT0105171

    Being a mother with anorexia: A phenomenological study of seeking and receiving professional support for white heterosexual women in the UK

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    Mothers are currently under‐represented in the literature on anorexia, including research on treatment, with most research focussed on female adolescents. This raises questions about how adult women and particularly those who are mothers, experience eating disorder treatment. This study provides a phenomenological exploration of lived experiences of seeking and receiving professional help and interactions with health professionals for six white heterosexual mothers who experienced anorexia while raising their children. Four themes are reported that capture the women's diverse experiences of seeking and receiving support for anorexia: (1) conflict between mothering and seeking help; (2) experiences of feeling blamed, poorly treated or misunderstood by health professionals; (3) positive experiences of seeking and receiving support; and (4) the importance of ongoing support. The women's experiences suggest that healthcare professionals should adopt a more holistic approach that acknowledges the subjective reality of the client (including their mother status) when working with mothers experiencing anorexia

    Recording therapy sessions: What do clients and therapists really think?

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    Aims: Recording therapy sessions has become part of routine practice amongst trainee psychotherapists. To date most research has focused on the benefits of recording sessions to support clinical supervision. There are few data about the benefits or risks for clients. This study aimed to explore the views of clients who had had their therapy sessions recorded and therapists who had recorded sessions. Design: Five clients and 25 therapists completed a qualitative survey, the results of which were analysed using thematic analysis. Findings: All clients and several therapists reported that the recording devices are soon forgotten. Both therapists and clients reported the benefits of recording as being purely for the therapist with none identified for clients. Conclusions: It was observed that clients perhaps did not always understand how recordings were used, suggesting the need for clearer practice guidance. © 2013 British Association for Counselling and Psychotherapy

    Leg disorders in broiler chickens : prevalence, risk factors and prevention

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    Broiler (meat) chickens have been subjected to intense genetic selection. In the past 50 years, broiler growth rates have increased by over 300% (from 25 g per day to 100 g per day). There is growing societal concern that many broiler chickens have impaired locomotion or are even unable to walk. Here we present the results of a comprehensive survey of commercial flocks which quantifies the risk factors for poor locomotion in broiler chickens.We assessed the walking ability of 51,000 birds, representing 4.8 million birds within 176 flocks.We also obtained information on approximately 150 different management factors associated with each flock. At a mean age of 40 days, over 27.6% of birds in our study showed poor locomotion and 3.3% were almost unable to walk. The high prevalence of poor locomotion occurred despite culling policies designed to remove severely lame birds from flocks. We show that the primary risk factors associated with impaired locomotion and poor leg health are those specifically associated with rate of growth. Factors significantly associated with high gait score included the age of the bird (older birds), visit (second visit to same flock), bird genotype, not feeding whole wheat, a shorter dark period during the day, higher stocking density at the time of assessment, no use of antibiotic, and the use of intact feed pellets. The welfare implications are profound. Worldwide approximately 261010 broilers are reared within similar husbandry systems.We identify a range of management factors that could be altered to reduce leg health problems, but implementation of these changes would be likely to reduce growth rate and production. A debate on the sustainability of current practice in the production of this important food source is required

    Mesenchymal Stromal Cells Are Retained in the Renal Cortex Independently of Their Metabolic State After Renal Intra-Arterial Infusion

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    The regenerative capacities of mesenchymal stromal cells (MSCs) make them suitable for renal regenerative therapy. The most common delivery route of MSC is through intravenous infusion, which is associated with off-target distribution. Renal intra-arterial delivery offers a targeted therapy, but limited knowledge is available regarding the fate of MSCs delivered through this route. Therefore, we studied the efficiency and tissue distribution of MSCs after renal intra-arterial delivery to a porcine renal ischemia-reperfusion model. MSCs were isolated from adipose tissue of healthy male pigs, fluorescently labeled and infused into the renal artery of female pigs. Flow cytometry allowed MSC detection and quantification in tissue and blood. In addition, quantitative polymerase chain reaction was used to trace MSCs by their Y-chromosome. During infusion, a minor number of MSCs left the kidney through the renal vein, and no MSCs were identified in arterial blood. Ischemic and healthy renal tissues were analyzed 30 min and 8 h after infusion, and 1-4 x 10(4) MSCs per gram of tissue were detected, predominantly, in the renal cortex, with a viability >70%. Confocal microscopy demonstrated mainly glomerular localization of MSCs, but they were also observed in the capillary network around tubuli. The infusion of heat-inactivated (HI) MSCs, which are metabolically inactive, through the renal artery showed that HI-MSCs were distributed in the kidney in a similar manner to regular MSCs, suggesting a passive retention mechanism. Long-term MSC survival was analyzed by Y-chromosome tracing, and demonstrated that a low percentage of the infused MSCs were present in the kidney 14 days after administration, while HI-MSCs were completely undetectable. In conclusion, renal intra-arterial MSC infusion limited off-target engraftment, leading to efficient MSC delivery to the kidney, most of them being cleared within 14 days. MSC retention was independent of the metabolic state of MSC, indicating a passive mechanism

    AirSWOT measurements of river water surface elevation and slope:Tanana River, AK

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    Fluctuations in water surface elevation (WSE) along rivers have important implications for water resources, flood hazards, and biogeochemical cycling. However, current in situ and remote sensing methods exhibit key limitations in characterizing spatiotemporal hydraulics of many of the world's river systems. Here we analyze new measurements of river WSE and slope from AirSWOT, an airborne analogue to the Surface Water and Ocean Topography (SWOT) mission aimed at addressing limitations in current remotely sensed observations of surface water. To evaluate its capabilities, we compare AirSWOT WSEs and slopes to in situ measurements along the Tanana River, Alaska. Root-mean-square error is 9.0cm for WSEs averaged over 1km(2) areas and 1.0cm/km for slopes along 10km reaches. Results indicate that AirSWOT can accurately reproduce the spatial variations in slope critical for characterizing reach-scale hydraulics. AirSWOT's high-precision measurements are valuable for hydrologic analysis, flood modeling studies, and for validating future SWOT measurements

    Nevirapine and Efavirenz Elicit Different Changes in Lipid Profiles in Antiretroviral- Therapy-Naive Patients Infected with HIV-1

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    BACKGROUND: Patients infected with HIV-1 initiating antiretroviral therapy (ART) containing a non-nucleoside reverse transcriptase inhibitor (NNRTI) show presumably fewer atherogenic lipid changes than those initiating most ARTs containing a protease inhibitor. We analysed whether lipid changes differed between the two most commonly used NNRTIs, nevirapine (NVP) and efavirenz (EFV). METHODS AND FINDINGS: Prospective analysis of lipids and lipoproteins was performed in patients enrolled in the NVP and EFV treatment groups of the 2NN study who remained on allocated treatment during 48 wk of follow-up. Patients were allocated to NVP (n = 417), or EFV (n = 289) in combination with stavudine and lamivudine. The primary endpoint was percentage change over 48 wk in high-density lipoprotein cholesterol (HDL-c), total cholesterol (TC), TC:HDL-c ratio, non-HDL-c, low-density lipoprotein cholesterol, and triglycerides. The increase of HDL-c was significantly larger for patients receiving NVP (42.5%) than for patients receiving EFV (33.7%; p = 0.036), while the increase in TC was lower (26.9% and 31.1%, respectively; p = 0.073), resulting in a decrease of the TC:HDL-c ratio for patients receiving NVP (−4.1%) and an increase for patients receiving EFV (+5.9%; p < 0.001). The increase of non-HDL-c was smaller for patients receiving NVP (24.7%) than for patients receiving EFV (33.6%; p = 0.007), as were the increases of triglycerides (20.1% and 49.0%, respectively; p < 0.001) and low-density lipoprotein cholesterol (35.0% and 40.0%, respectively; p = 0.378). These differences remained, or even increased, after adjusting for changes in HIV-1 RNA and CD4+ cell levels, indicating an effect of the drugs on lipids over and above that which may be explained by suppression of HIV-1 infection. The increases in HDL-c were of the same order of magnitude as those seen with the use of the investigational HDL-c-increasing drugs. CONCLUSION: NVP-containing ART shows larger increases in HDL-c and decreases in TC:HDL-c ratio than an EFV-containing regimen. Based on these findings, protease-inhibitor-sparing regimens based on non-nucleoside reverse transcriptase inhibitor, particularly those containing NVP, may be expected to result in a reduced risk of coronary heart disease
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