Validation of a food-frequency questionnaire assessment of carotenoid and vitamin E intake using weighed food records and plasma biomarkers: the method of triads model.

Background: Reliability or validity studies are important for the evaluation of measurement error in dietary assessment methods. An approach to validation known as the method of triads uses triangulation techniques to calculate the validity coefficient of a food-frequency questionnaire (FFQ).

Objective: To assess the validity of an FFQ estimates of carotenoid and vitamin E intake against serum biomarker measurements and weighed food records (WFRs), by applying the method of triads. Design: The study population was a sub-sample of adult participants in a randomised controlled trial of b-carotene and sunscreen in the prevention of skin cancer. Dietary intake was assessed by a self-administered FFQ and a WFR. Nonfasting blood samples were collected and plasma analysed for five carotenoids (a-carotene, b-carotene, b-cryptoxanthin, lutein, lycopene) and vitamin E. Correlation coefficients were calculated between each of the dietary methods and the validity coefficient was calculated using
the method of triads. The 95% confidence intervals for the validity coefficients were estimated using bootstrap sampling.

Results: The validity coefficients of the FFQ were highest for a-carotene (0.85) and lycopene (0.62), followed by b-carotene (0.55) and total carotenoids (0.55), while the lowest validity coefficient was for lutein (0.19). The method of triads could not be used for b-cryptoxanthin and vitamin E, as one of the three underlying correlations was negative.

Conclusions: Results were similar to other studies of validity using biomarkers and the method of triads. For many dietary factors, the upper limit of the validity coefficients was less than 0.5 and therefore only strong relationships between dietary exposure and disease will be detected.

Cost-effectiveness of cognitive-behavioural therapy and drug interventions for major depression

Objective: Antidepressant drugs and cognitive–behavioural therapy (CBT) are effective treatment options for depression and are recommended by clinical practice guidelines. As part of the Assessing Cost-effectiveness – Mental Health project we evaluate the available evidence on costs and benefits of CBT and drugs in the episodic and maintenance treatment of major depression.

Method: The cost-effectiveness is modelled from a health-care perspective as the cost per disability-adjusted life year. Interventions are targeted at people with major depression who currently seek care but receive non-evidence based treatment. Uncertainty in model inputs is tested using Monte Carlo simulation methods.

Results: All interventions for major depression examined have a favourable incremental cost-effectiveness ratio under Australian health service conditions. Bibliotherapy, group CBT, individual CBT by a psychologist on a public salary and tricyclic antidepressants (TCAs) are very cost-effective treatment options falling below $A10 000 per disability-adjusted life year (DALY) even when taking the upper limit of the uncertainty interval into account. Maintenance treatment with selective serotonin re-uptake inhibitors (SSRIs) is the most expensive option (ranging from $A17 000 to $A20 000 per DALY) but still well below $A50 000, which is considered the affordable threshold.

Conclusions: A range of cost-effective interventions for episodes of major depression exists and is currently underutilized. Maintenance treatment strategies are required to significantly reduce the burden of depression, but the cost of long-term drug treatment for the large number of depressed people is high if SSRIs are the drug of choice. Key policy issues with regard to expanded provision of CBT concern the availability of suitably trained providers and the funding mechanisms for therapy in primary care.

A practical condition for migration dynamic recrystallization

A readily evaluated condition for migration dynamic recrystallization is developed. It is based on the postulate that “the distance traversed by the boundary of a hypothetical growing grain in the time taken for the attainment of a recovery steady state must exceed the size of a critical nucleus”. A method for estimating the boundary mobility based on the kinetics of static recrystallization is also developed to facilitate evaluation of the condition. The derivation focuses first on developing an upper limit for the dynamically recrystallized grain size. This upper limit is only slightly higher than experimental values. The critical condition also agrees well with a limited set of experimental data. These data include the occurrence (and, in two cases, suppression) of dynamic recrystallization in Cu, Ni, Mg, α-Fe, γ-Fe and Al.

Expanding evidence for the multiple dangers of epidemic abdominal obesity

The waistline of America has been expanding now for decades,1 largely as a consequence of an obesogenic environment, with a car-worshipping culture and take-away lifestyle par excellence.2 No upper limit to the prevalence or extent of obesity is yet apparent, and many countries and communities worldwide are busily following the American lead. Accumulating research evidence suggests that the personal and economic costs of the obesity epidemic are immense,3 driven by the obesity-related increases in risk for conditions such as type 2 diabetes mellitus, the metabolic syndrome, cardiovascular disease (CVD), kidney disease, arthritis, cancer, asthma, and sleep-disordered breathing. In addition, decreases are apparent in self-esteem and quality of life.

Localized relaxational dynamics of succinonitrile

Succinonitrile (N≡C—CH₂—CH₂—C≡N) is a good ionic conductor, when doped with an ionic compound, at room temperature, where it is in its plastic crystalline phase (Long et al. Solid State Ionics 2003, 161, 105; Alarco et al. Nat. Mater. 2004, 3, 476). We report on the relaxational dynamics of the plastic phase near the two first-order phase transitions and on the effect of dissolving a salt in the plastic matrix by quasi-elastic neutron scattering. At 240 K, the three observed relaxations are localized and we can describe their dynamics (τ ≈ 1.7, 17, and 140 ps) to a certain extent from a model using a single molecule that was proposed by B_ée et al. allowing for all conformations in its unit cell (space group IM3M). The extent of the localized motion as observed is however larger than that predicted by the model and suggests that the isomerization of succinonitrile is correlated with a jump to the nearest neighbor site in the unit cell. The salt containing system is known to be a good ionic conductor, and our results show that the effect of the ions on the succinonitrile matrix is homogeneous. Because the isomerizations and rotations are governed by intermolecular interactions, the dissolved ions have an effect over an extended range. Due to the addition of the salt, the dynamics of one of the components (τ ≈ 17 ps) shows more diffusive character at 300 K. The calculated upper limit of the corresponding diffusion constant of succinonitrile in the electrolyte is a factor 30 higher than what is reported for the ions. Our results suggest that the succinonitrile diffusion is caused by nearest neighbor jumps that are localized on the observed length and time scales.

Dietary salt intake assessed by 24 h urinary sodium excretion in Australian schoolchildren aged 5–13 years

Objective To measure total daily salt intake using 24 h urinary Na excretion within a sample of Victorian schoolchildren aged 5–13 years and to assess discretionary salt use habits of children and parents.

Design Cross-sectional study.

Setting Completed within a convenience sample of independent primary schools (n 9) located in Victoria, Australia.

Subjects Two hundred and sixty children completed a 24 h urine collection over a school (34 %) or non-school day (66 %). Samples deemed incomplete (n 18), an over-collection (n 1) or that were incorrectly processed at the laboratory (n 3) were excluded.

Results The sample comprised 120 boys and 118 girls with a mean age of 9·8 (sd 1·7) years. The average 24 h urinary Na excretion (n 238) was 103 (sd 43) mmol/24 h (salt equivalent 6·0 (sd 2·5) g/d). Daily Na excretion did not differ by sex; boys 105 (sd 46) mmol/24 h (salt equivalent 6·1 (sd 2·7) g/d) and girls 100 (sd 41) mmol/24 h (salt equivalent 5·9 (sd 2·4) g/d; P = 0·38). Sixty-nine per cent of children (n 164) exceeded the recommended daily Upper Limit for Na. Reported discretionary salt use was common: two-thirds of parents reported adding salt during cooking and almost half of children reported adding salt at the table.

Conclusions The majority of children had salt intakes exceeding the recommended daily Upper Limit. Strategies to lower salt intake in children are urgently required, and should include product reformulation of lower-sodium food products combined with interventions targeting discretionary salt use within the home.

Oral versus parenteral antimicrobials for the treatment of cellulitis : a randomized non-inferiority trial

Objectives To determine whether outcomes for patients with cellulitis treated with oral antimicrobials are as good as for those who are treated with parenteral antimicrobials.Methods A prospective randomized non-inferiority trial was conducted at a tertiary teaching hospital in Melbourne, Australia. Participants were patients referred by the emergency department for treatment of uncomplicated cellulitis with parenteral antimicrobials. Patients were randomized to receive either oral cefalexin or parenteral cefazolin. Parenteral antimicrobials were changed to oral after the area of cellulitis ceased progressing. The primary outcome was days until no advancement of the area of cellulitis. A non-inferiority margin of 15% was set for the oral arm compared with the parenteral arm. Secondary outcomes were failure of treatment, pain, complications and satisfaction with care. This trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12611000685910).Results Twenty-four patients were randomized to oral antimicrobials and 23 to parenteral antimicrobials. Mean days to no advancement of cellulitis was 1.29 (SD 0.62) for the oral arm and 1.78 (SD 1.13) for the parenteral arm, with a mean difference of −0.49 (95% CI: −1.02 to +0.04). The upper limit of the 95% CI of the difference in means of +0.04 was below the 15% non-inferiority margin of +0.27 days, indicating non-inferiority. More patients failed treatment in the parenteral arm (5 of 23, 22%) compared with the oral arm (1 of 24, 4%), although this difference was not statistically significant (P = 0.10). Pain, complications and satisfaction with care were similar for both groups.Conclusions Oral antimicrobials are as effective as parenteral antimicrobials for the treatment of uncomplicated cellulitis.

Individual (co)variation in standard metabolic rate, feeding rate, and exploratory behavior in wild-caught semiaquatic salamanders

Repeatability is an important concept in evolutionary analyses because it provides information regarding the benefit of repeated measurements and, in most cases, a putative upper limit to heritability estimates. Repeatability (R) of different aspects of energy metabolism and behavior has been demonstrated in a variety of organisms over short and long time intervals. Recent research suggests that consistent individual differences in behavior and energy metabolism might covary. Here we present new data on the repeatability of body mass, standard metabolic rate (SMR), voluntary exploratory behavior, and feeding rate in a semiaquatic salamander and ask whether individual variation in behavioral traits is correlated with individual variation in metabolism on a whole-animal basis and after conditioning on body mass. All measured traits were repeatable, but the repeatability estimates ranged from very high for body mass (R = 0.98), to intermediate for SMR (R = 0.39) and food intake (R = 0.58), to low for exploratory behavior (R = 0.25). Moreover, repeatability estimates for all traits except body mass declined over time (i.e., from 3 to 9 wk), although this pattern could be a consequence of the relatively low sample size used in this study. Despite significant repeatability in all traits, we find little evidence that behaviors are correlated with SMR at the phenotypic and among-individual levels when conditioned on body mass. Specifically, the phenotypic correlations between SMR and exploratory behavior were negative in all trials but significantly so in one trial only. Salamanders in this study showed individual variation in how their exploratory behavior changed across trials (but not body mass, SMR, and feed intake), which might have contributed to observed changing correlations across trials.

Persisting side-to-side differences in bone mineral content, but not in muscle strength and tendon stiffness after anterior cruciate ligament reconstruction

Tendon stiffness may be involved in limiting peak musculoskeletal forces and thus may constitute an upper limit for bone strength. The patellar tendon bone (PTB) graft, which is harvested from the patellar tendon during surgical reconstruction of the anterior cruciate ligament (ACL), is an ideal scenario to test this hypothesis. Eleven participants were recruited who had undergone surgical reconstruction of the ACL with a PTB graft 1-10 years prior to study inclusion. As previously reported, there was no side-to-side difference in thigh muscle cross-sectional area, in maximum voluntary knee extension torque, or in patellar tendon stiffness, suggesting full recovery of musculature and tendon. However, in the present study bone mineral content (BMC), assessed by peripheral quantitative computed tomography, was lower on the operated side than on the control side in four regions studied (P = 0·0019). Differences were less pronounced in the two sites directly affected by the operation (patella and tibia epiphysis) when compared to the more remote sites. Moreover, significant side-to-side differences were found in BMC in the trabecular compartment in the femoral and tibial epiphysis (P = 0·004 and P = 0·047, respectively) with reductions on the operated side, but increased in the patella (P = 0·00016). Cortical BMC, by contrast, was lower on the operated side at all sites except the tibia epiphysis (P = 0·09). These findings suggest that impaired recovery of BMC following ACL reconstruction is not because of lack of recovery of knee extensor strength or patellar tendon stiffness. The responsible mechanisms still remain to be determined.

Distribution of carbon nanotubes in fresh ordinary Portland cement pastes: understanding from a two-phase perspective

Significant research advances have been made in the field of carbon nanotube (CNT) reinforced ordinary Portland cement (OPC) paste composites in recent years. However, the distribution of CNTs in fresh OPC paste is yet to be fully researched and quantified, thereby creating a technical barrier to CNT utilization in concrete construction. In this study, fresh OPC paste was treated as a two-phase material containing solid particles (cement grains) and liquid solutions (pore solutions). A centrifugation-based technique was proposed to separate these two phases and the presence of CNTs in each phase was quantified. UV-Vis spectrometry showed that the degree of dispersion can achieve above 90 wt% using polycarboxylate superplasticizer. The results suggested an upper limit of 0.26 wt% for CNT addition into water before mixing with OPC, and the dispersion was found to be stable for at least 4 hours. Based on scanning electron imaging, the adsorption phenomenon of CNTs on OPC grains with size less than 4 μm was discovered. Energy-dispersive X-ray spectroscopy indicated these adsorptive particles have lower Ca to Si ratio. It was observed that about 0.5 mg of CNTs per gram of OPC grains was adsorbed in solid OPC grains in typical fresh OPC pastes. On the basis of these results, a conceptual model was proposed for the distribution of CNTs in fresh OPC paste where about 33 wt% of the CNTs stay in pore solution and 65 wt% of CNTs are adsorbed on OPC grains.

Low-temperature compaction of Ti-6Al-4V powder using equal channel angular extrusion with back pressure

Equal channel angular extrusion (ECAE), with simultaneous application of back pressure, has been applied to the consolidation of 10 mm diameter billets of pre-alloyed, hydride-dehydride Ti-6Al-4V powder at temperatures ≤400 °C. The upper limit to processing temperature was chosen to minimise the potential for contamination with gaseous constituents potentially harmful to properties of consolidated product. It has been demonstrated that the application of ECAE with imposed hydrostatic pressure permits consolidation to in excess of 96% relative density at temperatures in the range 100-400 °C, and in excess of 98% at 400 °C with applied back pressure ≥175 MPa. ECAE compaction at 20 °C (back pressure = 262 MPa) produced billet with 95.6% relative density, but minimal green strength. At an extrusion temperature of 400 °C, the relative density increased to 98.3%, for similar processing conditions, and the green strength increased to a maximum 750 MPa. The relative density of compacts produced at 400 °C increased from 96.8 to 98.6% with increase in applied back pressure from 20 to 480 MPa, while Vickers hardness increased from 360 to 412 HV. The key to the effective low-temperature compaction achieved is the severe shear deformation experienced during ECAE, combined with the superimposed hydrostatic pressure.

Analysis of texture and R value variations in asymmetric rolling of if steel

Asymmetric rolling (ASR) is a potential process to reach better grain refinement than in conventional rolling, thus, can lead to better mechanical properties. It is not known, however, how the introduction of a shear component will change the ideal orientations of the textures, and consequently, the evolution of plastic anisotropy. To understand the effect of the added shear on texture evolution in ASR, a stability analysis is carried out in orientation space and the variations in the position and strength of the ideal orientations are analysed as a function of the shear component. Then, modelling of R values is presented for various cases. On that basis, it is shown that there is an upper limit for the shear component in asymmetric rolling that still retains the 〈1 1 1〉 ND fibre (ND: direction normal to the sheet) which is good for formability. It is also found that better persistence of the ND fibre can be obtained by cyclically alternating the shear component. The theoretical results are well supported by comparison to experimental evidences. © 2011 Elsevier B.V. All rights reserved.

Effects of a community-based salt reduction program in a regional Australian population

BACKGROUND: Salt reduction is a public health priority but there are few studies testing the efficacy of plausible salt reduction programs.

METHODS: A multi-faceted, community-based salt reduction program using the Communication for Behavioral Impact framework was implemented in Lithgow, Australia. Single 24-h urine samples were obtained from 419 individuals at baseline (2011) and from 572 at follow-up (2014). Information about knowledge and behaviors relating to salt was also collected.

RESULTS: Survey participants were on average 56 years old and 58 % female. Mean salt intake estimated from 24-h urine samples fell from 8.8 g/day (SD = 3.6 g/day) in 2011 to 8.0 (3.6) g/day in 2014 (-0.80, 95 % confidence interval -1.2 to -0.3;p < 0.001). There were significant increases in the proportion of participants that knew the recommended upper limit of salt intake (18 % vs. 29 %; p < 0.001), knew the importance of salt reduction (64 % vs. 78 %; p < 0.001) and reported changing their behaviors to reduce their salt intake by using spices (5 % vs. 28 %; p < 0.001) and avoiding eating out (21 % vs. 34 %; p < 0.001). However, the proportions that checked food labels (30 % vs. 25 %; p = 0.02) fell, as did the numbers avoiding processed foods (44 % vs. 35 %; p = 0.006). Twenty-six percent reported using salt substitute at the end of the intervention period and 90 % had heard about the program. Findings were robust to multivariable adjustment.

CONCLUSIONS: Implementation of this multi-faceted community-based program was associated with a ~10 % reduction in salt consumption in an Australian regional town. These findings highlight the potential of well-designed health promotion programs to compliment other population-based strategies to bring about much-needed reductions in salt consumption.

Impact of patient and environmental factors on capillary refill time in adults

OBJECTIVES: Capillary refill time (CRT) has been taught as a rapid indicator of circulatory status. The aim of this study was to define normal CRT in the Australian context and the environmental, patient, and drug factors that influence it.

METHODS: This prospective observational study included healthy adults at hospital clinics, workplaces, universities, and community groups. Volunteer participants provided their age, sex, ethnic group, and use of hypertensive or cardiac medications. Capillary refill time, ambient temperature, and patient temperature were recorded in a standard manner. Data were analyzed using descriptive statistics and regression analyses. The 95th percentile was used to define the upper limit of normal.

RESULTS: One thousand participants were included; 57% were women, 90% were white, and 21% were taking cardiac medications. The median CRT was 1.9 seconds (95th percentile, 3.5 seconds). The CRT increased 3.3% for each additional decade of age. The CRT was also on average 7% lower in men than in women. The CRT decreased by 1.2% per degree-Celsius rise of ambient temperature, independently of patient's temperature, and decreased by 5% for each degree-Celsius rise in patient temperature, independently of ambient temperature. On multivariant analysis, age, sex, ambient temperature, and patient temperature were statistically significant predictors of CRT, but together explain only 8% of the observed variability.

CONCLUSION: Capillary refill time varies with environmental and patient factors, but these account for only a small proportion of the variability observed. Its suitability as a reliable clinical test is doubtful.

Three dimensional stability charts for slopes based on limit analysis methods

This paper uses finite element upper and lower bound limit analysis to produce chart solutions for three-dimensional (3D) natural slopes for both short- and long-term stability. The presented chart solutions are convenient tools that can be used for preliminary design purposes. The rigorous limit analysis results in this paper were found to bracket the true factor of safety within ±10% or better, which can be used as a benchmark for the solutions from other methods. The depth of the slip surfaces is observed to be generally shallow for most analyzed cases, particularly for the long-term slope stability problem. In addition, it was found that using a two-dimensional (2D) analysis may lead to significant differences in estimating safety factors, which can differ by 2%–60% depending on the slope geometry and soil properties. Therefore, great care and judgement are required when applying 2D analyses to 3D slope problems.