Past-day recall of sedentary time: Validity of a self-reported measure of sedentary time in a university population

Background Sedentary behaviour is associated with several deleterious health consequences. Although device-based measures of sedentary time are available, they are costly and do not provide a measure of domain specific sedentary time. High quality self-report measures are necessary to accurately capture domain specific sedentary time, and to provide an alternative to devices when cost is an issue. In this study, the Past-day Adults’ Sedentary Time (PAST) questionnaire, previously shown to have acceptable validity and reliability in a sample of breast cancer survivors, was modified for a university sample and validity of the modified questionnaire was examined compared with activPAL. Methods Participants (n = 58, age = 18–55 years, 48% female, 66% students) were recruited from the University of Queensland (students and staff). They answered the PAST questionnaire, which asked about time spent sitting or lying down for work, study, travel, television viewing, leisure-time computer use, reading, eating, socialising and other purposes, during the previous day. Time reported for these questions was summed to provide a measure of total sedentary time. Participants also wore an activPAL device for the full day prior to completing the questionnaire and recorded their wake and sleep times in an activity log. Total waking sedentary time derived from the activPAL was used as the criterion measure. Correlation (Pearson's r) and agreement (Bland–Altman plots) between PAST and activPAL sedentary time were examined. Results Participants were sedentary (activPAL-determined) for approximately 66% of waking hours. The correlation between PAST and activPAL sedentary time for the whole sample was r = 0.50 [95% confidence interval (CI) = 0.28–0.67]; and higher for non-students (r = 0.63, 95% CI = 0.26–0.84) than students (r = 0.46, 95% CI = 0.16–0.68). Bland–Altman plots revealed that the mean difference between the two measures was 19 min although limits of agreement were wide (95% limits of agreement −4.1 to 4.7 h). Discussion The PAST questionnaire provides an acceptable measure of sedentary time in this population, which included students and adults with high workplace sitting. These findings support earlier research that questionnaires employing past-day recall of sedentary time provide a viable alternative to existing sedentary behaviour questionnaires.

Non-linear response of soil N2O emissions to nitrogen fertiliser in a cotton-fallow rotation in sub-tropical Australia

Nitrogen fertiliser is a major source of atmospheric N2O and over recent years there is growing evidence for a non-linear, exponential relationship between N fertiliser application rate and N2O emissions. However, there is still high uncertainty around the relationship of N fertiliser rate and N2O emissions for many cropping systems. We conducted year-round measurements of N2O emission and lint yield in four N rate treatments (0, 90, 180 and 270 kg N ha-1) in a cotton-fallow rotation on a black vertosol in Australia. We observed a nonlinear exponential response of N2O emissions to increasing N fertiliser rates with cumulative annual N2O emissions of 0.55 kg N ha-1, 0.67kg N ha-1, 1.07 kg N ha-1 and 1.89 kg N ha-1 for the four respective N fertiliser rates while no N response to yield occurred above 180N. The N fertiliser induced annual N2O EF factors increased from 0.13% to 0.29% and 0.50% for the 90N, 180N and 270N treatments respectively, significantly lower than the IPCC Tier 1 default value (1.0 %). This non-linear response suggests that an exponential N2O emissions model may be more appropriate for use in estimating emission of N2O from soils cultivated to cotton in Australia. It also demonstrates that improved agricultural N management practices can be adopted in cotton to substantially reduce N2O emissions without affecting yield potential.

Induced higher-order aberrations after laser in situ keratomileusis (LASIK) performed with wavefront-guided IntraLase femtosecond laser in moderate to high astigmatism

Background Wavefront-guided Laser-assisted in situ keratomileusis (LASIK) is a widespread and effective surgical treatment for myopia and astigmatic correction but whether it induces higher-order aberrations remains controversial. The study was designed to evaluate the changes in higher-order aberrations after wavefront-guided ablation with IntraLase femtosecond laser in moderate to high astigmatism. Methods Twenty-three eyes of 15 patients with moderate to high astigmatism (mean cylinder, −3.22 ± 0.59 dioptres) aged between 19 and 35 years (mean age, 25.6 ± 4.9 years) were included in this prospective study. Subjects with cylinder ≥ 1.5 and ≤2.75 D were classified as moderate astigmatism while high astigmatism was ≥3.00 D. All patients underwent a femtosecond laser–enabled (150-kHz IntraLase iFS; Abbott Medical Optics Inc) wavefront-guided ablation. Uncorrected (UDVA), corrected (CDVA) distance visual acuity in logMAR, keratometry, central corneal thickness (CCT) and higher-order aberrations (HOAs) over a 6 mm pupil, were assessed before and 6 months, postoperatively. The relationship between postoperative change in HOA and preoperative mean spherical equivalent refraction, mean astigmatism, and postoperative CCT were tested. Results At the last follow-up, the mean UDVA was increased (P < 0.0001) but CDVA remained unchanged (P = 0.48) and no eyes lost ≥2 lines of CDVA. Mean spherical equivalent refraction was reduced (P < 0.0001) and was within ±0.50 D range in 61 % of eyes. The average corneal curvature was flatter by 4 D and CCT was reduced by 83 μm (P < 0.0001, for all), postoperatively. Coma aberrations remained unchanged (P = 0.07) while the change in trefoil (P = 0.047) postoperatively, was not clinically significant. The 4th order HOAs (spherical aberration and secondary astigmatism) and the HOA root mean square (RMS) increased from −0.18 ± 0.07 μm, 0.04 ± 0.03 μm and 0.47 ± 0.11 μm, preoperatively, to 0.33 ± 0.19 μm (P = 0.004), 0.21 ± 0.09 μm (P < 0.0001) and 0.77 ± 0.27 μm (P < 0.0001), six months postoperatively. The change in spherical aberration after the procedure increased with an increase in the degree of preoperative myopia. Conclusions Wavefront-guided IntraLASIK offers a safe and effective option for vision and visual function improvement in astigmatism. Although, reduction of HOA is possible in a few eyes, spherical-like aberrations are increased in majority of the treated eyes.

First-Line afatinib versus chemotherapy in patients with non–small cell lung cancer and common epidermal growth factor receptor gene mutations and brain metastases

Introduction Metastatic spread to the brain is common in patients with non–small cell lung cancer (NSCLC), but these patients are generally excluded from prospective clinical trials. The studies, phase III study of afatinib or cisplatin plus pemetrexed in patients with metastatic lung adenocarcinoma with EGFR mutations (LUX-Lung 3) and a randomized, open-label, phase III study of BIBW 2992 versus chemotherapy as first-line treatment for patients with stage IIIB or IV adenocarcinoma of the lung harbouring an EGFR activating mutation (LUX-Lung 6) investigated first-line afatinib versus platinum-based chemotherapy in epidermal growth factor receptor gene (EGFR) mutation-positive patients with NSCLC and included patients with brain metastases; prespecified subgroup analyses are assessed in this article. Methods For both LUX-Lung 3 and LUX-Lung 6, prespecified subgroup analyses of progression-free survival (PFS), overall survival, and objective response rate were undertaken in patients with asymptomatic brain metastases at baseline (n = 35 and n = 46, respectively). Post hoc analyses of clinical outcomes was undertaken in the combined data set (n = 81). Results In both studies, there was a trend toward improved PFS with afatinib versus chemotherapy in patients with brain metastases (LUX-Lung 3: 11.1 versus 5.4 months, hazard ratio [HR] = 0.54, p = 0.1378; LUX-Lung 6: 8.2 versus 4.7 months, HR = 0.47, p = 0.1060). The magnitude of PFS improvement with afatinib was similar to that observed in patients without brain metastases. In combined analysis, PFS was significantly improved with afatinib versus with chemotherapy in patients with brain metastases (8.2 versus 5.4 months; HR, 0.50; p = 0.0297). Afatinib significantly improved the objective response rate versus chemotherapy in patients with brain metastases. Safety findings were consistent with previous reports. Conclusions These findings lend support to the clinical activity of afatinib in EGFR mutation–positive patients with NSCLC and asymptomatic brain metastases.