Measurement and prediction of energy expenditure in males during household and garden tasks

Participation in at least 30 min of moderate intensity activity on most days is assumed to confer health benefits. This study accordingly determined whether the more vigorous household and garden tasks (sweeping, window cleaning, vacuuming and lawn mowing) are performed by middle-aged men at a moderate intensity of 3-6 metabolic equivalents (METs) in the laboratory and at home. Measured energy expenditure during self-perceived moderate-paced walking was used as a marker of exercise intensity. Energy expenditure was also predicted via indirect methods. Thirty-six males [Xmacr (SD): 40.0 (3.3) years; 179.5 (6.9) cm; 83.4 (14.0) kg] were measured for resting metabolic rate (RMR) and oxygen consumption (V.O-2) during the five activities using the Douglas bag method. Heart rate , respiratory frequency, CSA (Computer Science Applications) movement counts, Borg scale ratings of perceived exertion and Quetelet's index were also recorded as potential predictors of exercise intensity. Except for vacuuming in the laboratory, which was not significantly different from 3.0 METs (P=0.98), the MET means in the laboratory and home were all significantly greater than 3.0 (Pless than or equal to0.006). The sweeping and vacuuming MET means were significantly higher (P

Impact of acute weight loss and/or thermal stress on rowing ergometer performance

Purpose: The impact of acute weight loss on rowing performance was assessed when generous nutrient intake was provided in 2 h of recovery after making weight. Methods: Competitive rowers (N = 17) completed four ergometer trials, each separated by 48 h. Two trials were performed after a 4% body mass loss in the previous 24 h (WT) and two were performed after no weight restrictions, that is, unrestricted (UNR). In addition, two trials (I X WT, I X UNR) were in a thermoneutral environment (NEUTRAL, mean 21.1 +/- SD 0.7 degrees C, 29.0 +/- 4.5% RH) and two were in the heat (HOT 32.4, +/- 0.4 degrees C, 60.4 +/- 2.7% RH). Trials were performed in a counterbalanced fashion according to a Latin square design. Aggressive nutritional recovery strategies (WT 2.3 g(.)kg(-11) carbohydrate, 34 mg-kg(-1) Na, 28.4 mL(.)kg(-1) fluid; UNR ad libitum) were employed in the 2 h after weigh-in. Results: Both WT (mean 2.1, 95% CI 0.7-3.4 s; P = 0.003) and HOT (4.1, 2.7 - 5.4 s; P < 0.001) compromised 2000-m time-trial performance. Whereas WT resulted in hypohydration, the associated reduction in plasma volume explained only part of the performance compromise observed (0.2 s for every 1% decrement) Moreover, WT did not influence core temperature or indices of cardiovascular function. Conclusions: Acute weight loss compromised performance, despite generous nutrient intake in recovery, although the effect was small. Performance decrements were further exacerbated when exercise was performed in the heat.

A Test of Performance of Breast MRI Interpretation in a Multicentre Screening Study

Objectives: The aim of this study was to assess the consistency and performance of radiologists interpreting breast magnetic resonance imaging (MRI) examinations. Materials and Methods: Two test sets of eight cases comprising cancers, benign disease, technical problems and parenchymal enhancement were prepared from two manufacturers' equipment (X and Y) and reported by 15 radiologists using the recording form and scoring system of the UK MRI breast screening study [(MAgnetic Resonance Imaging in Breast Screening (MARIBS)]. Variations in assessments of morphology, kinetic scores and diagnosis were measured by assessing intraobserver and interobserver variability and agreement. The sensitivity and specificity of reporting performances was determined using receiver operating characteristic (ROC) curve analysis. Results: Intraobserver variation was seen in 13 (27.7%) of 47 of the radiologists' conclusions (four technical and seven pathological differences). Substantial interobserver variation was observed in the scores recorded for morphology, pattern of enhancement, quantification of enhancement and washout pattern. The overall sensitivity of breast MRI was high [88.6%, 95% confidence interval (CI) 77.4-94.7%], combined with a specificity of 69.2% (95% CI 60.5-76.7%). The sensitivities were similar for the two test sets (P=.3), but the specificity was significantly higher for the Manufacturer X dataset (P

A phase I biological and pharmacologic study of the heparanase inhibitor PI-88 in patients with advanced solid tumors

Purpose: PI-88 is a mixture of highly sulfated oligosaccharides that inhibits heparanase, an extracellular matrix endoglycosidase, and the binding of angiogenic growth factors to heparan sulfate. This agent showed potent inhibition of placental blood vessel angiogenesis as well as growth inhibition in multiple xenograft models, thus forming the basis for this study. Experimental Design: This study evaluated the toxicity and pharmacokinetics of PI-88 (80-315 mg) when administered s.c. daily for 4 consecutive days bimonthly (part 1) or weekly (part 2). Results: Forty-two patients [median age, 53 years (range, 19-78 years); median performance status, 1] with a range of advanced solid tumors received a total of 232 courses. The maximum tolerated dose was 250 mg/d. Dose-limiting toxicity consisted of thrombocytopenia and pulmonary embolism. Other toxicity was generally mild and included prolongation of the activated partial thromboplastin time and injection site echymosis. The pharmacokinetics were linear with dose. Intrapatient variability was low and interpatient variability was moderate. Both AUC and C-max correlated with the percent increase in activated partial thromboplastin time, showing that this pharmacodynamic end point can be used as a surrogate for drug exposure, No association between PI-88 administration and vascular endothelial growth factor or basic fibroblast growth factor levels was observed. One patient with melanoma had a partial response, which was maintained for >50 months, and 9 patients had stable disease for >= 6 months. Conclusion: The recommended dose of PI-88 administered for 4 consecutive days bimonthly or weekly is 250 mg/d. PI-88 was generally well tolerated. Evidence of efficacy in melanoma supports further evaluation of PI-88 in phase II trials.

Acute weight loss followed by an aggressive nutritional recovery strategy has little impact on on-water rowing performance

Objectives: To assess the influence of moderate, acute weight loss on on-water rowing performance when aggressive nutritional recovery strategies were used in the two hours between weigh in and racing. Methods: Competitive rowers (n=17) undertook three on-water 1800 m time trials under cool conditions ( mean (SD) temperature 8.4 (2.0)degrees C), each separated by 48 hours. No weight limit was imposed for the first time trial-that is, unrestricted body mass (UNR1). However, one of the remaining two trials followed a 4% loss in body mass in the previous 24 hours (WT-4%). No weight limit was imposed for the other trial (UNR2). Aggressive nutritional recovery strategies (WT-4%, 2.3 g/kg carbohydrate, 34 mg/kg Na+, and 28.4 ml/kg fluid; UNR, ad libitum) were used in the first 90 minutes of the two hours between weigh in and performance trials. Results: WT-4% had only a small and statistically non-significant effect on the on-water time trial performance ( mean 1.0 second, 95% confidence interval (CI) 20.9 to 2.8; p=0.29) compared with UNR. This was despite a significant decrease in plasma volume at the time of weigh in for WT-4% compared with UNR (-9.2%, 95% CI -12.8% to -5.6%; p

Cloud adoption:prioritizing obstacles and obstacles resolution tactics using AHP

The enormous potential of cloud computing for improved and cost-effective service has generated unprecedented interest in its adoption. However, a potential cloud user faces numerous risks regarding service requirements, cost implications of failure and uncertainty about cloud providers' ability to meet service level agreements. These risks hinder the adoption of cloud. We extend the work on goal-oriented requirements engineering (GORE) and obstacles for informing the adoption process. We argue that obstacles prioritisation and their resolution is core to mitigating risks in the adoption process. We propose a novel systematic method for prioritising obstacles and their resolution tactics using Analytical Hierarchy Process (AHP). We provide an example to demonstrate the applicability and effectiveness of the approach. To assess the AHP choice of the resolution tactics we support the method by stability and sensitivity analysis. Copyright 2014 ACM.

The Reasonable Man on Tour

The "reasonable man" standard is one to which all rational persons should subscribe. The author relates the standard to the travel industry and the fate of travels.

Fig. 2. Lithology, water and total carbon content, cumulative grain-size distribution, and quartz, feldspar, and mica contents of core sequence Lz1013 from south-western Beaver Lake

A 100 cm long sediment sequence was recovered from Beaver Lake in Amery Oasis, East Antarctica, using gravity and piston corers. Sedimentological and mineralogical analyses and the absence of micro and macrofossils indicate that the sediments at the base of the sequence formed under glacial conditions, probably prior to c. 12 500 cal. yr BP. The sediments between c. 81 and 31 cm depth probably formed under subaerial conditions, indicating that isostatic uplift since deglaciation has been substantially less than eustatic sea-level rise and that large areas of the present-day floor of Beaver Lake must have been subaerially exposed following deglaciation. The upper 31 cm of the sediment sequence were deposited under glaciomarine conditions similar to those of today, supporting geomorphic observations that the Holocene was a period of relative sea-level highstand in Amery Oasis.

Tratamento Endovascular de Patologia da Aorta Torácica: Experiência Institucional

Introdução: O tratamento endovascular da aorta torácica (TEVAR) é uma modalidade terapêutica emergente que tem vindo a revolucionar a abordagem de diferentes tipos de patologia da aorta na sua localização torácica. Objetivos: Avaliação da experiência institucional do serviço de angiologia e cirurgia vascular. Métodos: Análise retrospetiva da série consecutiva de todos os doentes com patologia da aorta torácica e/ou toracoabdominal submetidos a TEVAR na nossa instituição. Foram excluídos aqueles com uso concomitante de endopróteses fenestradas/ramificadas abdominais. Resultados: Desde abril de 2005 até abril de 2014, 79 doentes foram submetidos a TEVAR, com idade média de 66 ± 12,83 anos (máx: 86; mín: 14). As indicações incluíram: 46 aneurismas (58%), 17 dissecções aórticas clássicas tipo B (22%), 13 no contexto de outras síndromes aórticas agudas (16%), 2 por ateroembolismo (3%) e um por fístula aortoesofágica (1%). Na patologia aneurismática, a distribuição anatómica da doença foi a seguinte: 5 na aorta ascendente e arco aórtico (11%), 35 na aorta torácica descendente (76%) e 6 toracoabdominal (13%). O diâmetro médio das dilatações aneurimáticas foi de 69,64 mm (máx: 150 mm). A rotura foi uma apresentação da patologia em 21,5% dos doentes (n = 17); 20,9% dos doentes tinham antecedentes de cirurgia aórtica prévia. A dissecção aórtica tipo B complicada foi a segunda indicação mais comum, sendo de apresentação aguda em 13 (76%) e crónica em 4 (24%). As complicações na base da intervenção foram dilatação aneurismática em 35% (n = 6), malperfusão com isquemia de órgão alvo 47% (n = 8), desconhecida em 18% (n = 3). Foi realizada extensão distal com stent descoberto (Petticoat) em 9 casos (41,2%) e foram realizados procedimentos adjuvantes em 18% (stenting renal n = 2; stenting ilíaco n = 1). Dentro das outras síndromes aórticas agudas, o TEVAR foi realizado no contexto de úlcera aórtica penetrante (n = 4), hematoma intramural (n = 4) e os restantes por rotura/pseudoaneurisma (n = 5). As endopróteses utilizadas foram: 32 Valiant Medtronic®, 15 TAG Gore®, 25 Zenith TX2 Cook®, 2 Zenith TX1 Cook®, uma Relay Plus®, 3 Talent Medtronic® e outras em 1%. A mediana de dias de cuidados intensivos foi 2 (intervalo 0-42) e a mediana de suporte tranfusional foi de 2 UCE. A taxa de mortalidade aos 30 dias ou intra-hospital foi de 18% (n = 14). Atendendo ao timing da cirurgia, a taxa de mortalidade aferida nos casos electivos foi de 8% (4/50) e nos urgentes atinge os 35% (10/29). Intraoperatoriamente foram tratadas 7 complicações relacionadas com vaso de acesso membro, 2 casos de dissecção aórtica iatrogénica, um caso de trombose arterial inferior e um endoleak tipo IA. A taxa de reintervenções foi de 17%, com as seguintes indicações: 9 endoleaks, 2 isquemias mesentéricas e 2 fístulas aortoesofágicas. Conclusões: A série apresentada traduz uma experiência institucional favorável com resultados reprodutíveis e que o TEVAR é um procedimento seguro e eficaz para o tratamento de diferentes patologias da aorta torácica, quando comparado com o tratamento cirúrgico aberto.

Athletic groin pain (part 2): a prospective cohort study on the biomechanical evaluation of change of direction identifies three clusters of movement patterns

Background: Athletic groin pain (AGP) is prevalent in sports involving repeated accelerations, decelerations, kicking and change-of-direction movements. Clinical and radiological examinations lack the ability to assess pathomechanics of AGP, but three-dimensional biomechanical movement analysis may be an important innovation. Aim: The primary aim was to describe and analyse movements used by patients with AGP during a maximum effort change-of-direction task. The secondary aim was to determine if specific anatomical diagnoses were related to a distinct movement strategy. Methods: 322 athletes with a current symptom of chronic AGP participated. Structured and standardised clinical assessments and radiological examinations were performed on all participants. Additionally, each participant performed multiple repetitions of a planned maximum effort change-of-direction task during which whole body kinematics were recorded. Kinematic and kinetic data were examined using continuous waveform analysis techniques in combination with a subgroup design that used gap statistic and hierarchical clustering. Results: Three subgroups (clusters) were identified. Kinematic and kinetic measures of the clusters differed strongly in patterns observed in thorax, pelvis, hip, knee and ankle. Cluster 1 (40%) was characterised by increased ankle eversion, external rotation and knee internal rotation and greater knee work. Cluster 2 (15%) was characterised by increased hip flexion, pelvis contralateral drop, thorax tilt and increased hip work. Cluster 3 (45%) was characterised by high ankle dorsiflexion, thorax contralateral drop, ankle work and prolonged ground contact time. No correlation was observed between movement clusters and clinically palpated location of the participant's pain. Conclusions: We identified three distinct movement strategies among athletes with long-standing groin pain during a maximum effort change-of-direction task. These movement strategies were not related to clinical assessment findings but highlighted targets for rehabilitation in response to possible propagative mechanisms. Trial registration number NCT02437942, pre results.

A combination of amino acids and caffeine enhances sprint running capacity in a hot, hypoxic environment.